FRN Research Report June 2011: Post-Treatment Behavior and Outcomes among Young Adults after Integrated Rehab Treatment

Background

Does a patient’s age affect addiction treatment outcomes? Foundations Recovery Network (FRN) studied former patients for one year post-treatment in order to measure lasting treatment outcomes. This study, conducted from 2008 to 2010, found that patient age may correlate with readiness to change, affecting long-term drug and alcohol abstinence following residential treatment.

Studies show that a patient’s readiness to change influences the outcome of addiction treatment. The University of Rhode Island Change Assessment (URICA) self-report is a test used to measure a patient’s readiness to change.

Our Findings

All patients in this study attended one of Foundations Recovery Network’s Dual Diagnosis treatment programs, which address both substance abuse and mental illness. Patients included in this survey were prescribed a minimum of 30-day residential treatment with the goal of alleviating addiction and stabilizing mental health.

Patients were divided into two age groups: ages 18-25 and ages 26 and older. Patients were measured for the following parameters:

  • Completion of prescribed rehab treatment
  • Readiness to change (readiness to abstain from drugs or alcohol)
  • Drug and alcohol use before treatment
  • Drug and alcohol use after treatment (relapse) up to six months after treatment

Pre-Admission Drug and Alcohol Use

FRN data shows that younger patients are more likely than older patients to have used drugs in the 30 days leading up to admission while older patients tilt more toward alcohol use. A suggested reason for this difference is that the younger patients range in age from 18-25, preventing much of this group from legally obtaining alcohol, while the older population has little trouble obtaining alcohol.

Completion of Treatment and Readiness to Change by Age Group

Despite a longer average stay in treatment, younger patients are less likely than their older counterparts to complete their full prescribed treatment at an FRN facility, reflecting the role that each client’s “readiness to change” plays. Under a survey of patients from 2008-2010, patients aged 25 and younger averaged 34.3 days at a facility compared with 31.2 days for older patients. However, only 87.4% of these younger patients actually completed their prescribed program versus 91% of older patients.

A key determinant of program completion may be readiness to change. A number of studies show that readiness to change influences recovery.1 Patients were asked to fill out the University of Rhode Island Change Assessment (URICA) self-report measure. The URICA includes several questions intended to measure the client’s readiness to change. By measuring subscales of the client’s status in the Stages of Change (Precontemplation, Contemplation, Action or Maintenance), and then combining the subscales (C + A + M – PC), researchers hope to correlate the client’s desire to change with treatment outcomes.

The 25 and younger patients had an average URICA score of 10.6 compared with a score of 11 for older patients. Although the differences are slight, this readiness to change appears to drive older patients to complete treatment fully.

Post-Treatment Outcomes of Patients Based on Age

Regardless of their age, patients who leave FRN actually improve their sobriety during the 60 days post-treatment. Whereas only 52% of patients 25 and younger are sober in the first 30 days upon discharge, 59.5% are sober at six months. A similar trend occurs for the over 25 group, whose sobriety levels increase from 68% at one month to 75.2% after six months.

Post Treatment Alcohol Sobriety

These data suggest that patients may quickly relapse upon leaving treatment, but eventually return to sobriety and that older patients are more likely to remain sober over time (possibly because they began treatment with a greater readiness to change.)

Post-Treatment Drug Sobriety

A similar trend occurs with drugs, but patients are far more likely to stay clean from drugs than alcohol, likely because patients are more likely to admit into a facility for alcohol than for drugs.

Outcomes After Integrated Rehab Treatment

Also driving the positive outcomes of older patients is the use of 12-Step meetings. Regardless of their age, the vast majority of patients (76% of 25 and younger and 73.4% of over 25) are likely to attend a 12-Step meeting in the six months upon leaving a facility. However, older patients are more likely to go to these meetings regularly and are more likely to have a sponsor. The frequency of attendance and the presence of a sponsor – along with readiness to change – appear to be the drivers of sobriety for patients.

Interestingly, younger people are nearly twice as likely as older patients to take part in sober-living households, but this opportunity does not seem to influence sobriety.

Improvements of Substance Use and Psychiatric Symptoms after Integrated Rehab Treatment

Also of note, participants completed a baseline interview within four days of arriving at the facility, followed by one month and six month post-discharge interviews. Regardless of their age, patients reported sharp improvements in both their psychiatric, alcohol, drug, legal and family situations six months after receiving treatment. The goal of Dual Diagnosis treatment is tackling both substance abuse and psychological barriers, and this data suggests the FRN strategy is working for patients in both age groups, 18-25 and 26 and older.

The 25 and younger group had the best improvement in medical condition, while the older group had the sharpest improvement in alcohol, drug, legal and family issues. Age didn’t seem to have an impact on improved psychiatric issues. The one area that saw the least improvement was employment; in fact, those over 25 saw a slight increase in employment problems, probably because they were trying to re-adjust to work situations following getting sober.

Discussion

Several findings became clear with this research:

  • Regardless of their age, patients who leave FRN improve their sobriety during the 60 days post-treatment.
  • Differences in readiness to change and treatment retention appear based on patient age. Patients over 25 years of age tend to be both more ready to change and more willing to remain in treatment until prescribed completion.
  • We can assume that younger patients fail to complete treatment more often because of the correlation between level of readiness to change and young adulthood. We can conclude that younger adults (ages 18-25) tend to arrive in treatment with less readiness to change.
  • It is important to note that patients who volunteer to participate in research may be more ready to change and remain more actively involved in treatment than patients who decline to participate in research.
  • This data suggests that patients of all ages may quickly relapse upon leaving treatment, but eventually return to sobriety. This initial relapse may be due to the adjustment period after residential treatment.
  • Positive patient outcomes correlate with patients’ willingness to participate consistently in 12-Step meetings after treatment.
  • Regardless of their age, the vast majority of patients are likely to attend a 12-Step meeting in the six months upon leaving a facility. However, older patients are more likely to regularly go to these meetings and are more likely to have a sponsor.
  • The frequency of post-treatment 12-Step meeting attendance and the presence of a sponsor –along with readiness to change – appear to be the drivers of sobriety for patients.