Data Collection Systems

Studies of Substance Abuse Treatment

The Drug Abuse Reporting Program (DARP) was the first of three major studies funded by the National Institute on Drug Abuse (NIDA) to evaluate community-based substance abuse treatment in [Page 190]the United States on a national basis. The study was conducted over 20 years and began with a dataset based on about 44,000 admissions to 52 federally supported treatment agencies in 1969–73 and a sample of patients were followed longitudinally and interviewed six and 12 years after their admit date. Treatment modalities represented in DARP include methadone maintenance, therapeutic community, outpatient drug free, and detoxification. This data set provided some of the first evidence on the long-term success rates of treatment for drug addiction, identified important covariates related to success or failure, and also provided information that allowed the researchers to characterize patterns of drug use and abuse more specifically. For instance, DARP data demonstrated that many of the addicts studied suffered several temporary relapses after achieving abstinence, but over half of them had no period of daily drug use longer than two years.

The Treatment Outcome Prospective Study (TOPS) was the second major national effort to study substance abuse treatment in the United States. TOPS collected data from 11,750 clients in 10 U.S. cities who were admitted to substance abuse treatment in 1979–81. Treatment modalities covered in TOPS include methadone maintenance, outpatient drug-free and long-term residential including therapeutic communities. TOPS was begun at a time when new patterns of drug use were emerging as the heroin epidemic was subsiding, and was intended to provide a framework for specialized studies such as the cost-effectiveness of drug abuse treatment, patterns and impact of comorbidity, and the impact of legal involvement. Findings from TOPS include the decline of daily opiate use and the rise of polysubstance abuse in the United States, evidence that providing drug abuse treatment was cost effective when compared to costs associated with crime, and evidence that treatment was effective in reducing illicit drug use both during and after treatment. TOPS data also showed that legal pressure to enter treatment was not detrimental to effective treatment and that methadone maintenance programs were more likely to have high client retention if they offered flexible dosing, frequent urine monitoring, and comprehensive services.

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