PDF (Drugnet Ireland, issue 19)
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On 11 September 2006, Noel Ahern TD, Minister of State with responsibility for drugs strategy, launched the report of findings from the Research Outcomes Study in Ireland (ROSIE).1 A team at the National University of Ireland, Maynooth, completed the study on behalf of the National Advisory Committee on Drugs (NACD). This report focuses on outcomes for adult opiate users at one year following entry to treatment. Minister Ahern welcomed ‘this timely research which provides much needed information on how well people do when they go for drug treatment’. Dr Des Corrigan, chairperson of the NACD, reiterated the report’s main conclusion – ‘that investment in opiate treatment services leads to benefits to the individual drug user, to their family and to the rest of the community and that this investment must be continued’.
At baseline, the study recruited 404 opiate users aged 18 years or over entering treatment at inpatient facilities (hospitals, residential programmes and prisons) or outpatient settings (community-based clinics, health board clinics and general practitioners). The opiate users selected were entering treatment for the first time, or were returning to treatment after a period of absence, at any one of 54 services nationwide. The interview schedule collected data on:
· drug use in the 90 days preceding the interview, specifically, type, frequency, quantity and cost;
· measures of harmful practices and consequences;
· health status, using a self-rated physical and psychosocial health assessment;
· social functioning, including accommodation, employment, and involvement in crime;
· mortality, using information obtained from the participants’ contacts and the General Mortality Register.
The participants were interviewed at intake (baseline), at six months following entry to treatment (not presented) and again at one year after intake. The baseline data were collected between September 2003 and July 2004. Of the 404 opiate users interviewed at intake, 373 (92%) were traced one year later, of whom 305 were interviewed. Of the other 68 who were traced, 66 did not wish to participate in the follow-up interview and two had died. The characteristics of the 99 individuals who were not interviewed one year after intake did not differ from those of the interviewees. The data presented in this article compares the experience at intake to that at one year for the 305 participants interviewed at both time-points.
There was a reduction in the proportion of participants who reported using heroin in the 90 days preceding data collection, from 81% at intake to 48% at one year. The average frequency of heroin use by participants in a 90-day period reduced from 43 out of 90 days at intake to 16 out of 90 days at one year. The average quantity of heroin consumed each day over a 90-day period decreased from 0.9 grams at intake to 0.3 grams at one year. There was a corresponding reduction in the average amount spent on heroin on a typical day, from €75 at intake to €24 at follow-up.
There were large reductions in the proportions of participants who reported use of non-prescribed methadone, cocaine powder, crack cocaine and non-prescribed benzodiazepines at one year compared to the baseline interview. There were smaller reductions in cannabis and alcohol use over the same time period.
The proportion of participants reporting use of more than one drug decreased from 78% at intake to 50% one year later.
The proportion of participants who reported injecting drug use in the 90 days preceding data collection decreased from 46% at intake to 29% at one year. The reported average number of days injecting over a 90-day period decreased from 21 out of 90 days at intake to 9 out of 90 days at one year. There was a corresponding decrease in the average number of times participants injected per day, from 1.8 at intake to 0.8 at one year. There was a small decrease in the proportion reporting an overdose, from 7% at intake to 4% at follow-up.
Between intake and one-year follow-up, there were reductions in the numbers of participants reporting 5 of 10 common symptoms of physical illness experienced by drug users; there were reductions also in the numbers of men reporting 6 of 12 selected symptoms of mental illness experienced by drug users. Women participants did not report reductions in the selected symptoms of mental illness.
The average number of visits by participants to a general practice, or to employment, educational or homeless services, had increased at the time of follow-up.
The proportion of participants reporting involvement in acquisitive crime decreased from 31% at intake to 14% at one year. in addition, the proportion reporting selling or supplyng drugs reduced from 31% at intake to 11% at one year. Of the 305 participants interviewed at both time points, 7% were not using drugs at the time of entry to treatment, while 27% were not using drugs one year later. Of the 285 participants for whom treatment status was reported, 30% completed their index treatment, 14% were transferred to another treatment site, 18% did not complete their index treatment and 38% were still in their index treatment. At the one-year follow-up interview, 82% of these 285 participants were either continuing in their index treatment or had commenced another treatment episode.
Adult opiate users reported positive changes in drug use, risk behaviour, health status, service contact and criminal behaviour at one year following entry to treatment, which indicates that treatment for these opiate users was beneficial. According to the authors, drug treatment contributed to changes in the lives of opiate users, but it is not feasible to isolate the exact contribution of the treatment, on its own, from that of other influences.
1. Cox G, Comiskey C, Kelly P, Cronly J (2006) ROSIE Findings 1: Summary of 1-year outcomes. Dublin: National Advisory Committee on Drugs.
|Issue Title:||Issue 19, Autumn 2006|
|Page Range:||pp. 1-2|
|Publisher:||Health Research Board|
|Accession Number:||HRB (Available)|
|Subjects:||HJ Treatment method > Treatment outcome|
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HJ Treatment method > AOD disorder treatment method > AOD replacement method (substitution) > Methadone maintenance
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