Abstract: Es besteht ein Defizit an systematischen Informationen zur Struktur- und Prozessqualität von Suchtbehandlungen. Auch die einzelnen Einrichtungen haben zum grössten Teil ungenügende Informationen über die Qualität ihrer Behandlung. Solche Informationen sind aber besonders wichtig, um die Qualität von Suchtbehandlungen anzupassen und weiterzuentwickeln. Zu diesem Zweck sollten Qualitätsmodelle implementiert und entsprechende Indikatoren erhoben werden. Das Ziel der Studie war die Erarbeitung von grundlegenden Informationen zum Thema “Qualitätserfassung in Suchtbehandlungen” und die Entwicklung von Instrumenten zur Erhebung von Behandlungsqualität. Die Basis dazu bildete einerseits eine umfassende Recherche nach Literatur und Modellen zur Erhebung von Behandlungsqualität bzw. zur Qualitätssicherung von Behandlungsprogrammen für Drogenabhängige. Anderseits wurden dreizehn Interviews mit Expert/innen aus der Praxis und der Forschung inhaltsanalytisch ausgewertet, um Qualitätsindikatoren der Struktur und des Prozesses von Behandlungen zu eruieren. Im Rahmen der Literaturrecherche konnten keine für die Suchtbehandlung spezifische Modelle gefunden werden. Ein auf der Grundlage von Recherche und Interviews entwickeltes Modell ermöglicht die Durchführung von Qualitätskontrolle, -sicherung und -verbesserung der Struktur-, Prozess- und Ergebnisqualität. Die Erhebung der Strukturqualität findet mit dem MIDES (Modulares Instrument zur Deskription von Suchtbehandlung) statt. Mit bestehenden und neuentwickelten Instrumenten werden die Prozessqualität (z.B. KLIBS “Klient/innen-Befragung zur Suchtbehandlung”) und die Ergebnisqualität erfasst.

Abstract: The cost of treating approximately 150,000 participants represented by the CALDATA study sample in 1992 was $209 million. Each day of treatment paid for itself on the day it was received, primarily through an avoidance of crime. The benefits of alcohol and other drug treatment outweighed the costs of treatment by ratios from 4:1 to greater than 12:1, depending on the type of treatment. Benefits after treatment persisted through the second year of follow-up for the limited number of participants followed for as long as 2 years. This suggests that projected cumulative lifetime benefits of treatment will be substantially higher than the shorter-term figures. The level of criminal activity declined by two-thirds from before treatment to after treatment. The greater the length of time spent in treatment, the greater the percentage of reduction in criminal activity. Declines of approximately two-fifths also occurred in the use of alcohol and other drugs from before treatment to after treatment. Approximately one-third reductions in hospitalizations were reported from before treatment to after treatment. For each type of treatment studied, there were slight or no differences in effectiveness based on gender, age, or ethnicity. Overall, treatment did not have a positive effect on the economic situation of the participants during the study period. 38 tables and 11 figures

Abstract: Naltrexone – an effective aid in the psychosocial rehabilitation process of former opiate dependent patients [Article in German] Ladewig D Naltrexon is an longterm opioid antagonist, which can be used in the psychosocial rehabilitation process of former dependents on opiates. It was established that there were less opiates used during the treatment with Naltrexon. The exclusive delivery of Naltrexon cannot protect from relapse and has to be completed with psychotherapeutic measures. Naltrexone. Kleber HD Naltrexone (Trexan R), a long acting, orally affective narcotic antagonist was approved by the Food & Drug Administration in November, 1984 for use as an adjunct in the treatment of Opioid Addiction. This research capsule will explore what is known about naltrexone, and the most appropriate ways of using the drug. Naltrexone treatment in a jail work-release program. Brahen LS, Henderson RK, Capone T, Kordal N. Inmates with a history of opiate addiction have traditionally been excluded from jail work-release programs because of their high likelihood of returning to drug use. In 1972, a new jail work-release program was begun in the Nassau County (New York) Jail, to which addicted inmates, who had formerly been excluded automatically, could request admission if they took the opiate blocking agent naltrexone. Inmates received naltrexone twice a week and had routine urine checks for drugs of abuse and an alcohol breath test when indicated. Psychological and vocational testing and weekly psychotherapy sessions were provided. For those no longer incarcerated, the adjacent hospital outpatient clinic was available for naltrexone treatment. Naltrexone has proved to be a completely effective opiate blocking agent with no major side effects in 691 patients over a 10-year period.