Long-Term Outcomes of Aftercare Participation following Various Forms of Drug Abuse Treatment in Scotland

Abstract

Due to high relapse rates after leaving treatment, drug users are often recommended to participate in some form of lower intensity continuing care. The importance of aftercare is widely accepted, but little empirical data are available about the effectiveness of continuing services over longer periods of time and following various treatment modalities. In this study, we assessed the influence of various forms of aftercare on treatment outcomes and service utilization over a 33-month period among a naturalistic cohort of 653 drug users treated in prison or community settings, as part of the Drug Outcome Research in Scotland (DORIS study). Although participation in aftercare after initial treatment is rather unusual, the odds of having experienced a drug-free period (after 8 months) (OR = 1.91, 95% CI 1.10–3.33) and of being abstinent from heroin (after 33 months) (OR= 0.56, 95% CI 0.34–0.94) almost doubled. Program aftercare was of little additional value after intensive residential treatment, but particularly important after prison-based and community treatment and if combined with self-help participation. Consequently, attractive and fitted aftercare services should be offered as an integrated part of various treatment modalities.