Evaluating the impact of community-based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES)
Version of Record online: 12 JUL 2012
© 2012 The Authors. Addiction © 2012 Society for the Study of Addiction
Volume 107, Issue 11, pages 1998–2008, November 2012
How to Cite
McKetin, R., Najman, J. M., Baker, A. L., Lubman, D. I., Dawe, S., Ali, R., Lee, N. K., Mattick, R. P. and Mamun, A. (2012), Evaluating the impact of community-based treatment options on methamphetamine use: findings from the Methamphetamine Treatment Evaluation Study (MATES). Addiction, 107: 1998–2008. doi: 10.1111/j.1360-0443.2012.03933.x
- Issue online: 5 OCT 2012
- Version of Record online: 12 JUL 2012
- Accepted manuscript online: 7 MAY 2012 07:19AM EST
- Manuscript Accepted: 2 MAY 2012
- Manuscript Revised: 5 JAN 2012
- Manuscript Received: 23 NOV 2011
- National Health and Medical Research Council
- Australian Government Department of Health and Ageing
- psychiatric comorbidity;
- substance abuse;
- HIV risk;
To evaluate the impact of community-based drug treatment on methamphetamine use using inverse probability of treatment-weighted (IPTW) estimators to derive treatment effects.
A longitudinal prospective cohort study with follow-ups at 3 months, 1 year and 3 years. Treatment effects were derived by comparing groups at follow-up. IPTW estimators were used to adjust for pre-treatment differences between groups.
Sydney and Brisbane, Australia.
Participants were methamphetamine users entering community-based detoxification (n = 112) or residential rehabilitation (n = 248) services and a quasi-control group of methamphetamine users (n = 101) recruited from the community.
Frequency of methamphetamine use between interviews (no use, less than weekly, 1–2 days per week, 3+ days per week), continuous abstinence from methamphetamine use, past month methamphetamine use and methamphetamine dependence.
Detoxification did not reduce methamphetamine use at any follow-up relative to the quasi-control group. Relative to quasi-control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of methamphetamine use at 3 months [odds ratio (OR) = 0.23, 95% confidence interval (CI) 0.15–0.36, P < 0.001), with a marked attenuation of this effect at 1 year (OR 0.62, 95% CI 0.40–0.97, P = 0.038) and 3 years (OR = 0.71, 95% CI 0.42–1.19, P = 0.189). The greatest impact was for abstinence: for every 100 residential rehabilitation clients there was a gain of 33 being continuously abstinent at 3 months, with this falling to 14 at 1 year and 6 at 3 years.
Community-based residential rehabilitation may produce a time-limited decrease in methamphetamine use, while detoxification alone does not appear to do so.