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Drug Rehab

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Shorter-Term Residential Programs. Typically these programs are of one month to six weeks duration and are provided to people immediately after detoxification. These programs are provided by both government and non-government providers and cater for the needs of clients who require post detoxification supervision in a short-term context with an emphasis on cognitive/behavioural and relapse prevention interventions.

The available literature suggests that this type of service should be targeted to people who have:

• less entrenched histories of substance dependence;
• previous histories of out-patient treatment failure;
• no previous history of treatment failure in residential settings;
• no significant cognitive impairment;
• less severe co-morbidity (mild depression or anxiety, stable psychotic conditions)
• better psycho-social supports including employment opportunities.

There is some evidence that the short-term residential treatment programs have a higher success rate, in terms of completion of treatment and post treatment outcomes, for clients with primary alcohol dependence than for clients with primary opioid dependence. In terms of the treatment approach, a review of the literature suggests that such programs are not effective as a post detoxification intervention unless they incorporate a progression to structured options such as supervised half-way house accommodation or daily/weekly participation in a non- residential treatment program.

Longer-Term Residential Programs have been identified in practice and in the research literature as providing significant benefit for people with severe alcohol and drug use problems and complex needs. In terms of the benefits of residential treatment, the most common predictor of successful outcome has been length of stay in treatment, though it is not clear if additional benefits are seen after six months (Ernst & Young 1996). The available literature suggests that longer-term (60 – 100 days and 100 and above days) treatment services should be targeted to:

• people with severe alcohol and drug use problems, in particular primary opioid dependence, where these problems pose a significant risk to the health and welfare of the person themselves and others;
• people for whom non-residential or short term treatment options have failed to address their treatment needs in the past;
• people whose home setting or social circumstances are not supportive of non-residential treatment options, to the extent that such treatment options are unlikely to succeed.
• people with significant co-morbid disorders, requiring longer stabilisation.

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