Psychologists Hendree Jones, PhD, research director for the Center for Addiction and Pregnancy (CAP) at Johns Hopkins University, and Thomas McLellan, PhD, director of the Treatment Research Institute at the University of Pennsylvania, participated in an expert panel at a March 30 congressional hearing on gauging drug-treatment program effectiveness.
Jones and McLellan joined Nora Volkow, MD, director of the National Institute on Drug Abuse (NIDA); Charles Currie, administrator of the Substance Abuse and Mental Health Services Administration (SAMHSA); and other addiction treatment experts in testifying at the hearing, which was chaired by Rep. Mark Souder (R-Ind.). In his remarks, Souder emphasized the importance, in an era of tight budgets, of focusing limited treatment funding on the most effective treatment methods.
Indeed, studying the effectiveness of different programs is key, said Jones. "Measuring outcomes and conducting studies at the center has taught us much about specific treatment strategies that work with the population we treat," she explained. "That information informs our protocols and improves our practice."
She described the work done at CAP to help drug-addicted pregnant women and their children. CAP patients spend two to three months in treatment during their pregnancies, and 75 percent of the mothers at CAP have drug-free deliveries and are drug-free three months after treatment, Jones said. Also, 81 percent of their children are born drug-free, she added.
But many addicted people don't have access to such services. According to a 2002 survey by SAMHSA, 22.8 million people in the United States needed treatment for a serious alcohol or drug problem, but only 2.3 million received it, Currie noted.
However, when addicts do get treatment, he said, more often than not it helps. He cited a SAMHSA study from 1997 that found a 50 percent reduction in drug use after one year of treatment.
To assess a program's effectiveness with participants, he said, SAMHSA looks at a number of overall criteria, including:
Abstinence from drug and alcohol use.
Increased access to services and increased retention and treatment.
Increased employment or return to school.
Decreased criminal justice involvement.
Increased stabilization in family and living conditions and connectedness to the community.
Like Jones and Currie, Volkow said that treatment programs can work. For example, she described some of NIDA's recent successes, including a new drug for opiate addiction--buprenorphine--that allows some doctors to treat patients in their own offices rather than a public clinic. However, she emphasized that treatment is a long-term process.
McLellan agreed. "We have effective treatments," he said. "We don't have cures."