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The predictive validity of the dependence syndrome in opiate abusers
T A Kosten1, M S Bianchi, T R Kosten
1Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut 06519.
The American Journal of Drug and Alcohol Abuse
|January 1, 1992
Summary
Dependence severity did not consistently predict treatment success in opiate addicts. Substance use frequency was a better predictor of program retention, especially for non-White individuals.
Area of Science:
- Addiction research
- Clinical psychology
- Substance abuse treatment
Background:
- The dependence syndrome concept suggests severity predicts treatment outcomes.
- Previous research primarily focused on alcohol dependence.
- Limited data exists on opiate addiction and dependence severity's predictive validity.
Purpose of the Study:
- To investigate if opiate dependence severity predicts treatment success.
- To examine prediction of program retention, treatment compliance, and psychological functioning.
- To assess predictive validity in a 1-year follow-up of opiate addicts.
Main Methods:
- 1-year follow-up study of 48 opiate addicts.
- Assessed dependence severity, program retention, treatment compliance, and psychological functioning.
- Controlled for demographics, withdrawal severity, and substance use frequency.
Main Results:
- Addicts' self-reported substance use frequency best predicted program retention.
- Opiate dependence severity predicted retention only in White addicts.
- For non-White addicts, concurrent depression and cocaine abuse were stronger predictors of retention.
Conclusions:
- Opiate dependence severity alone is not a reliable predictor of treatment success across all populations.
- Substance use frequency and co-occurring mental health issues are critical factors in opiate addiction treatment retention.
- Further research is needed to understand ethnic variations in treatment response.