Planned versus actual duration of drug abuse treatment. Reconciling observational and experimental evidence

The purpose of the study was to evaluate the associations of planned versus actual duration of drug abuse treatment with psychosocial outcomes and drug use at follow-up. A randomized trial was conducted in a modified therapeutic community in which 444 clients were assigned to programs with planned durations of either 3 or 6 months. Outcomes were psychosocial measures assessing changes in mood and in stage of behavior change between admission and exit and return to drug use and patterns of use 2 to 6 months after exit. Planned duration was not associated with any of the outcomes. A longer actual length of stay was, however, associated with greater improvements in the mood variables; lower rates of drug use at follow-up; and, among those using drugs at follow-up, a longer time from exit to first drug use. Intention-to-treat analyses supported these results. Randomized controlled trials are needed to distinguish the effects of planned duration and actual length of stay.