The impact of methadone and drug-free treatment on criminal behavior.

The present study was initiated to evaluate the effect of methadone versus drug-free treatment on a series of criminal involvement measures. A 50% random sample of the 776 clients who had registered with the Central Intake Unit over a one year period was selected for intensive study. Data were collected through examination of intake and treatment files for pre- and post-admission time periods. Arrest, conviction and incarceration rates as well as correctional status were measured and compared across pre-treatment, intake and three month post-intake periods. The arrest rate for the total sample decreased radically from 92.8% upon entering treatment to 8% after three months in treatment. The subsequent rates at 6, 9 and 12 months decreased in a fairly consistent manner. This trend was similar in the methadone, drug-free, and methadone/drug-free groups for either arrests, convictions or incarceration rates with time in treatment. The relationship between arrests and employment and drug use was also examined. No association was found between use of opiates as measured by urinalysis results and frequency of arrest. Similarly, arrest rates showed no significant association with employment rates during the first nine months of treatment, although the comparison at twelve months was significant with only 16.7% of those employed clients being arrested.

Theoretical and clinical approaches to the treatment of adolescent drug addiction.

Psychologists, social workers, addiction specialists, and occupational therapists often find themselves faced with clients who not only are addicted but also have personal, family, and social problems. These combined problems make the drug-abusing client an extremely difficult one to work with. Occupational therapists have a particular challenge in that they must not only understand and analyze their clients' occupational behavior but also their needs as addicts. This paper describes an approach to adolescent addiction that presents a clinical and theoretical consideration that could be helpful to professionals who work with addicted or drug-abusing clients. In the approach a fusion must be made between the client and the therapist or treatment program. The fusion is temporary but long enough to provide opportunities for clients to work through their feelings of anger, aggression, and sadism, as well as their ego and superego problems. To understand all aspects of their use of drugs, an easily memorized two-dimensional scheme is drawn by the client and therapist together and is used to formulate a treatment plan. Separation from the therapist or program is an essential part of treatment. At this time the client is given the kind of emotional support required to establish new relationships.

Heroin addiction as an occupation: traditional addicts and heroin-addicted polydrug users.

This paper discusses work aimed at exploring the possibility that heroin addiction is a form of work, i.e., it is an occupation no different in social or psychological value than any other vocation. The question of whether or not a heroin addict in treatment is "out of work" is also explored.

Drug use and employment patterns before and during treatment.

This paper was initiated to study the effect of outcome measures as they relate to indication of treatment success. Results have shown that after the third month in treatment, drug use decreases very little. Time in treatment in significantly related to urin-analysis results during the first 3 months; that is, those clients who were to remain in treatment for longer periods were those whose average opiate use during the first 3 months were lowest. We also found that no relationship exists between pretreatment opiate use and opiate use during any evaluation time period. Analysis of employment change rate for a 1-year's period indicate that those employed at intake remain employed and those unemployed remain so. Change in opiate use during any evaluation period had no influence whatsoever on employment.