Psychosocial Treatment for Drug Dependence

Författare

Mats Fridell

Redaktör

Mats Berglund
Sten Thelander
Egon Jonsson

Summary, in English

All randomized controlled studies published in international peer-reviewed journals up to July 1999 were meta-analysed with the aim of studying the effect of psychosocial interventions on patients with drug dependence. Systematic literature searches were administered by SBU. In all 104 studies were screened and rated according to the 12 dimension quality score of SBU. The analyses in the chapter studied the effects on drug abuse and retention and aimed at specific domains of research; 1) efficacy of treatment of opiate abuse/ depen¬dence (n=24) containing 5.721 patients, 2) of cocaine abuse/dependence, 26 studies with 5.956 patients), 3) cannabis abuse, (7 studies with 707 patients), 4) of treatment methods for patients with mental illness and (9 studies), 5) residential treatment containing 9 studies and 4.867 patients, 6) finally for structure interventions with other outcome measures than drug use, 5 studies with 461 patients. A clinical methodological model elaborated from Wolberg´s (1988) classification, divided the interventions into three groups: ranging in therapist skills, goals and costs from a) supportive, b) reeducational to c) psychotherapeutic intervenetions. Effect sizes were calcylated using Hedge´s d and groups of interventions were weighted with the root of the variance. In opiate abuse re-educational and psycho-therapeutic interventions had a significant but low Wd of .23 and .29 respectively. Re-educational interventions only gained a significant but low effect size of Wd = .24 in treatment of cocaine abuse. Family therapies finally were efficient in the treatment of teenage cannabis abusers in with an intact family network. Supportive interventions, generally, were not effective. For retention as outcome measure, finally, psychotherapies had a significant medium effect size in retention of opiate abuse (Wd= .56, n=3.380) and a low but significant positive effect size in retention of cocaine abuse (Wd= .30, n=3.381).

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