Mortality 5 Years After Detoxification and Counseling as Indicated by Psychometric Tests

Residential detoxification of substance abusers, using medication to alleviate withdrawal symptoms, often fails to ensure further abstention and predict which clients have the greatest risk of morbidity after detoxification. Prolonging the detoxification period with a counseling period has been shown to enhance compliance to counseling. Sixty-one (61) substance abusers (mean age: 31.3 years; 22 women) with a mean length of abuse of 16 years in 1993-1994 were tested using two psychometric tests and then followed up in 1999 according to mortality. Mean value on Antonovsky's Sense of Coherence (SOC) scale was 2.98 and on Hopkins Symptom Checklist (HSCL-24) was 2.06, indicating postdetoxification coping problems and distress. Thirteen (13) abusers died during follow-up. Cox regression of mortality showed increased risk in men, and also an increased risk of dying in the observation period with lower SOC score (p <.01), but not with increasing HSCL-24 score. Logistic regression indicated a 3.6 times higher risk of dying in the observation period if the SOC score was 1 point lower (on a scale range from 1 to 5). An increased mortality in drug addicts leaving the facility with an SOC value below 3.00 after a 4-week detoxification and counseling stay is thus strongly supported by the data. Antonovsky's SOC scale thus seems to be a good indicator of future mortality.