This study will explore existing research data and reports from various agencies and journals in order to answer the question: does the length of treatment improve the success of people who are addicted to drugs and/or alcohol? I have chosen several scientific journal articles concerning the relationship between the success rate of substance abusing clients and their length of time spent in treatment. Equal numbers of studies, both supporting and not supporting my hypothesis, will be used in order to present an unbiased, objective evaluation.
In reality the dependent variable that I am interested in measuring is the success rate of substance abusers, with the independent variable being the length of treatment. As this is secondary research, for the purpose of this paper and evaluations of other articles, the dependent variable of my research will be the hypothesis of this paper. The support of this question/idea, or the lack of support will be provided by the independent variables, ie; journal articles and/or data compiled. An operational definition of my independent variable will be the reliability and validity of the journal articles selected for the study. One important factor for the operational definition will be what questions the articles ask and how well the findings they produce would support or not support my hypothesis. In fact,
I used only studies that mentioned a relation in patient success or outcome and length of treatment, regardless of whether the outcome; or dependent variable, was positive or negative. There are other factors that have to be considered as variables and how they might influence the outcome of a clients treatment, ie; motivation for treatment, denial, family/support systems or the lack of them, level of addiction, and mental health (Cruse, 1989). I have no way of measuring these and will look at length of treatment in general as duration of treatment may change such variables itself. National archive data obtained from SAMHSA ( Substance Abuse and Mental Health Services Administration, 1998) will also be referenced in order to support the correlation between length of treatment and the success of substance abusers. This data may also help identify and measure extraneous variables. I chose these sources for data in order to obtain information about the population I am studying from the largest samples possible. Although some of the studies that I chose ( specifically the studies not supporting this papers hypothesis) utilized small sample numbers of one hundred or less, most of the research that I reviewed used five hundred or more subjects. The smaller studies were not chosen purposely, but chosen instead on the basis of availability. Duration and outcome of treatment data
originating from the national system of drug/alcohol treatment centers, and compiled by the federal agency SAMHSA was used also because of the large numbers involved.
An accepted normal course of treatment for a person physically addicted to alcohol and/or drugs would be; one to seven days of detoxification, and two to four weeks of in-patient care followed by variable lengths of out-patient treatment.
While I have already mentioned some factors which might affect the outcome of a substance abusers treatment, there is also another
issue involved that might take precedence over other issues and that is; health care cost and insurance coverage. The cost for treatment of addictions is not cheap; averaging in our area of the country about 3-4 hundred dollars a day for in-patient care, and approximately $ 100.00 dollars an hour for out-patient services (Fisher & Harrison, 1997). Obviously the cost of these services not only affects the availability of treatment for people, but also the duration of treatment. People with no health care insurance may not even consider treatment as an option, unless treatment is mandated by the judicial system. People arrested for driving under the
influence, or domestic violence, are often forced to undergo treatment for substance abuse, and in these cases medicaid usually pays the bill. In any case people are not free to choose addiction treatment options without first considering methods and/or ability to pay for these services. Most people receiving treatment have some form of medical insurance, and insurance companies decide whether or not treatment, and what length of treatment is justified.
The largest problem concerning the collection and interpretation of data will most likely be the effect of the extraneous variables mentioned earlier. Even with these variables taken into consideration a positive correlation between length of treatment and the outcome for substance abusers should persist unless there is a strong influence from one, or a combined effect from several variables. Addiction is a powerful disease and if one has other negative influences, or other medical problems, or perhaps even a lack of financial resources, they may not succeed regardless of the amount and/or length of treatment that they receive.
1) Cruse, Sharon Wegscheider, 1989. Another Chance. Palo Alto: Science and Behavior Books Inc.
2) Fisher, G., & Harrison, T. 1997. Substance Abuse. Boston: Allyn and Bacon.
3) SAMHSA, 1998. Drug Abuse Treatment System Survey. Http://www.icpsr.umich.edu.SAMHDA/other.html#datss