Facilitating Treatment Entry among Out-of-Treatment Injection Drug Users

Objectives: High risk injection practices are common among injecting drug users (IDUs), even following intervention efforts. Moreover, relapse to risk behaviors has been reported among those who initiate risk reduction. Substance abuse treatment offers the potential to reduce or eliminate injecting...

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Bibliographic Details
Published inPublic health reports (1974) Vol. 113; no. Suppl 1; pp. 116 - 128
Main Authors Booth, R E, Kwiatkowski, C, Iguchi, M Y, Pinto, F, John, D
Format Journal Article
LanguageEnglish
Published United States U.S. Public Health Service 01.06.1998
SAGE PUBLICATIONS, INC
Subjects
Adolescent
Adult
Aged
AIDS
Behavior Therapy
Cocaine
Colorado
Coupons
Drug abuse
Female
Health Promotion
Health Services Accessibility
Heroin
HIV
Humans
Injections
Male
Medical syringes
Methadone
Middle Aged
Motivation
Needles
Public health
Substance Abuse Treatment Centers
Substance-Related Disorders - psychology
Substance-Related Disorders - therapy
Colorado
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Summary:Objectives: High risk injection practices are common among injecting drug users (IDUs), even following intervention efforts. Moreover, relapse to risk behaviors has been reported among those who initiate risk reduction. Substance abuse treatment offers the potential to reduce or eliminate injecting risk behaviors through drug cessation. We report on the effectiveness of two intervention strategies in facilitating treatment entry among out-of-treatment IDUs: motivational interviewing (MI), an intervention developed to help individuals resolve their ambivalence about behavior change, and free treatment for 90 days. These conditions were compared with an intervention focusing on a hierarchy of safer injecting practices, referred to here as risk reduction (RR), and no free treatment. Methods: Nearly 200 out-of-treatment IDUs were randomly assigned to one of four experimental conditions: MI/free treatment, MI/no free treatment, RR/free treatment, and RR/no free treatment. Regardless of assignment, we assisted anyone desiring treatment by calling to schedule the appointment, providing transportation, and waiving the intake fee. Results: Overall, 42% of study participants entered treatment. No significant differences were found between MI and RR; however, 52% of those assigned free treatment entered compared with 32% for those who had to pay. Other predictors of treatment entry included prior treatment experiences, perceived chance of contracting acquired immunodeficiency syndrome (AIDS) greater than 50%, "determination" stage of change, greater frequency of heroin injecting, and fewer drug-using friends. Conclusion: These findings support the importance of removing barriers to treatment entry.
ISSN:0033-3549
1468-2877