The relationship between legal factors and attrition from a residential drug abuse treatment program

This article examines the legal involvement of 438 clients randomized to three- and six-month versions of a residential drug abuse treatment program with respect to early attrition (before 40 days in treatment) and later attrition (40-79 days in treatment). Concern about legal problems was reported by 21% of subjects in response to an open-ended question about factors that led to admission; 42% had other legal circumstances that were determined either from documented evidence of legal involvement from chart review or from self-report through structured questioning about legal status. For those with "concern about legal problems" the early attrition rate was 16%, compared with 33% for those with no legal factors--odds ratio (OR) .38 with 95% confidence interval (95% CI) (.20,.73) and the later attrition rate was 25%, OR .76, 95% CI (.39,1.48). Those subjects with "legal circumstances" only had an early attrition rate of 29%--OR .86, 95% CI (.54,1.37) and a later attrition rate of 19%, OR .53, 95% CI (.29,.98) compared to those with no legal factors. There was little evidence of confounding in any of these results from adjusted analyses. Findings suggest that only self-reported concern about legal status as a problem mentioned at entry to treatment is significantly associated with lower early attrition and there is no significant relationship of legal factors with later attrition.