The National Treatment Outcome Research Study (NTORS): 4-5 year follow-up results

FRANÇAIS :
La NTORS est la première étude prospective nationale sur les résultats de traitement au Royaume Uni. L'échantillon 418 patients en traitement dans 54 services différents et selon 4 modalités. Les taux d'abstinence ont augmenté après le traitement aussi bien chez les usagers en traitement résidentiel que communautaire. Pour la plupart des variables étudiées (usage d'héroïne, de méthadone non prescrite, de benzodiazépines et de partage du matériel d'injection) les diminutions sont évidentes au bout d'un an. En revanche, la consommation de cocaïne ou d'alcool n'a pas diminué au bout de 4-5 ans par rapport à son niveau lors de l'entrée en traitement.
ENGLISH :
Aims:The National Treatment Outcome Research Study (NTORS) is the first prospective national study of treatment outcome among drug misusers in the United Kingdom. NTORS investigates outcomes for drug misusers treated in existing services in residential and settings. Design, setting and participants: The study used a longitudinal, prospective cohort design. Data were collected by structured interviews at intake to treatment, 1 year, 2 years and at 4-5 years. The sample comprised 418 patients from 54 agencies and four treatment modalities. Measurements: Measures were taken of illicit drug use, injecting and sharing injecting equipment, alcohol use, psychological health and crime. Findings: Rates of abstinence from illicit drugs increased after treatment among patients from both residential and community (methadone) programmes. Reductions were found for frequency of use of heroin, non-prescribed methadone, benzodiazepines, injecting and sharing of injecting equipment. For most variables, reductions were evident at 1 year with outcomes remaining at about the 1 year level or with further reductions. Crack cocaine and alcohol outcomes at 4-5 years were not significantly different from intake. Conclusions: Substantial reductions across a range of problem behaviours were found 4-5 years after patients were admitted to national treatment programmes delivered under day-to-day. The less satisfactory outcomes for heavy drinking and use of crack cocaine suggest the need for services to be modified to tackle these problems more effectively. Despite differences between the United Kingdom and the United States in patient populations and in treatment programmes, there are many similarities between the two countries in outcomes from large-scale, multi-site studies. (Review' s abstract)