Treatment for Substance Use Disorders

Subsections:

Related Chapters:

Looking for a referral to, or more information about, mental health or substance use treatment services? The American Board of Preventive Medicine provides this service to locate physicians who are certified in specialists in Addiction Medicine

The federal Substance Abuse and Mental Health Services Administration has a free, confidential National Helpline at 1-800-662-HELP (4357).
"SAMHSA’s National Helpline, 1-800-662-HELP (4357), (also known as the Treatment Referral Routing Service) is a confidential, free, 24-hour-a-day, 365-day-a-year, information service, in English and Spanish, for individuals and family members facing mental and/or substance use disorders. This service provides referrals to local treatment facilities, support groups, and community-based organizations. Callers can also order free publications and other information."
SAMHSA's website also offers a free, confidential Behavioral Health Treatment Services Locator.

21. Poly-Drug Users In Treatment

"While it is generally assumed that polydrug use is a hard-to-treat condition, results from large treatment outcome studies in Europe show significant reductions in multiple drug use among highly problematic users. Nevertheless, managing the care of problem polydrug users requires long-term treatment planning with attention to individual needs and multidisciplinary teams working together with flexible and sometimes innovative treatment options."

European Monitoring Centre for Drugs and Drug Addiction, "Polydrug Use: Patterns and Responses" (Lisboa, Portugal: 2009), p. 26.
http://www.emcdda.europa.eu/at...

22. Admissions to Treatment With Marijuana as Primary Substance Through Criminal Justice Referral in the US, 2012
Detail of Admissions to Treatment Through Criminal Justice System for Those Aged 12 and Older with Marijuana as Primary Substance

Total Number
154,739
Detailed Criminal Justice Referral Source Percent of Total
Probation/Parole 44.3
State/Federal Court 15.7
Formal Adjudication 12.2
DUI/DWI 2.5
Other Legal Entity 9.5
Diversionary Program 3.0
Prison 2.0
Other 10.8

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2002-2012. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-71, HHS Publication No. (SMA) 14-4850. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, p. 5, and Table 2.6, p. 63.
http://www.samhsa.gov/data/sit...
http://www.samhsa.gov/data/sit...

23. Admissions to Treatment for Alcohol with Secondary Drug Use in the US, 2012

"• Admissions for primary abuse of alcohol with secondary abuse of drugs represented 18 percent of TEDS admissions aged 12 and older in 2012 [Table 1.1b].
"• The average age at admission for primary alcohol with secondary drug abuse was lower, at 37 years, than for abuse of alcohol alone (41 years) [Table 2.1a].
"• Non-Hispanic Whites accounted for 58 percent of admissions for primary alcohol with secondary drug abuse (41 percent were males and 17 percent were females). Non-Hispanic Blacks made up 23 percent of admissions (18 percent were males and 6 percent were females) [Table 2.3a].
"• Almost half (45 percent) of admissions for primary alcohol with secondary drug abuse first became intoxicated by age 14, and 93 percent first became intoxicated before age 21 (the legal drinking age) [Table 2.5].
"• Admissions for primary alcohol with secondary drug abuse were less likely to be in treatment for the first time than alcohol-only admissions (35 vs. 46 percent) [Table 2.5].
"• Among admissions referred to treatment by the criminal justice/DUI source, admissions for alcohol with secondary drug abuse were more likely than alcohol-only admissions to have been referred to treatment as a condition of probation/parole (30 vs. 17 percent) [Table 2.6].
"• Among admissions for alcohol with secondary drug abuse, marijuana and smoked cocaine were the most frequently reported secondary substances (25 percent and 8 percent, respectively) [Table 3.8]."

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2002-2012. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-71, HHS Publication No. (SMA) 14-4850. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, pp. 14-15.
http://www.samhsa.gov/data/sit...
http://www.samhsa.gov/data/sit...

24. Admissions to Treatment for Primary Alcohol Abuse Alone, in the US, 2012

"• Admissions for abuse of alcohol alone, with no secondary drug abuse, represented 21 percent of TEDS admissions aged 12 and older in 2012 [Table 1.1b].
"• The average age at admission among admissions for alcohol only was 41 years. The average age at admission for alcohol with secondary drug was 37 years [Table 2.1a]. Admission for alcohol only or with secondary drug was the most likely reason for admissions aged 30 and older [Table 2.1b].
"• Non-Hispanic Whites made up 66 percent of all alcohol-only admissions (approximately 46 percent were males and 21 percent were females) [Table 2.3a].
"• Eighty-seven percent of alcohol-only admissions reported that they first became intoxicated before age 21, the legal drinking age. Almost one-third (30 percent) first became intoxicated by age 14 [Table 2.5].
"• Among admissions referred to treatment by the criminal justice/DUI source, alcohol-only admissions were more likely than admissions for alcohol with secondary drug abuse to have been referred as a result of a DUI/DWI offense (28 vs. 16 percent) [Table 2.6].
"• Some 34 percent of alcohol-only admissions aged 16 and older were employed compared with 22 percent of all admissions that age [Table 2.8]."

Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. Treatment Episode Data Set (TEDS): 2002-2012. National Admissions to Substance Abuse Treatment Services. BHSIS Series S-71, HHS Publication No. (SMA) 14-4850. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014, pp. 12-13.
http://www.samhsa.gov/data/sit...
http://www.samhsa.gov/data/sit...

25. Proportion of Clients in Treatment in the US with Alcohol Alone, Other Substances Alone, or In Combination, 2012

"Facilities were asked to estimate the proportions of clients in treatment on March 30, 2012, by substance abuse problem treated (alcohol abuse only, drug abuse only, or both alcohol and drug abuse).
"• On March 30, 2012, 44 percent of clients were in treatment for both alcohol and drug abuse, 38 percent were in treatment for drug abuse only, and 18 percent were in treatment for alcohol abuse only.
"• By facility operation, the highest proportion of clients in treatment for abuse of both alcohol and drugs was in tribal government-operated facilities (57 percent). For abuse of drugs only, the highest proportion of clients was in private for-profit facilities (51 percent); for abuse of alcohol only, the highest proportion was in federal-operated facilities (35 percent).
"• At facilities with a primary focus of substance abuse treatment services, 40 percent of clients were in treatment for abuse of both alcohol and drugs. Facilities with other foci of services reported similar proportions of clients in treatment for abuse of both alcohol and drugs (45 to 56 percent)."

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 34.
http://www.samhsa.gov/data/DAS...

26. Treatment Clients in the US with Co-Occurring Substance Abuse and Mental Disorders, 2012

"Facilities were asked to estimate the proportion of clients in treatment with diagnosed co-occurring mental and substance abuse disorders.
"• On March 30, 2012, 46 percent of clients who were in treatment had a diagnosed co-occurring mental and substance abuse disorder.
"• The highest proportions of clients with co-occurring mental and substance abuse disorders were in federal government-operated facilities (61 percent) and in facilities with a primary focus of mental health services (74 percent)."

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 34.
http://www.samhsa.gov/data/DAS...

27. Treatment Participation among Prison Inmates

"In 2004, about 642,000 State prisoners were drug dependent or abusing in the year before their admission to prison. An estimated 258,900 of these inmates (or 40%) had taken part in some type of drug abuse program (table 10). These inmates were more than twice as likely to report participation in selfhelp or peer counseling groups and education programs (35%) than to receive drug treatment from a trained professional (15%).
"In Federal prison, a higher percentage of drug dependent or abusing inmates (49%) reported taking part in some type of drug abuse programs. Nearly 1 in 3 took part in drug abuse education classes, and 1 in 5 had participated in self-help or peer counseling groups. Overall, 17% took part in drug treatment programs with a trained professional, and 41% had participated in other drug abuse programs."

Mumola, Christopher J., and Karberg, Jennifer C., "Drug Use and Dependence, State and Federal Prisoners, 2004," (Washington, DC: Bureau of Justice Statistics, Dept. of Justice, Oct. 2006) NCJ-213530, p. 9.
http://www.bjs.gov/content/pub...

28. Treatment Admissions for Marijuana in the US, 1992-2002, and Referrals from the Criminal Justice System

" A recent issue of The DASIS Report2 examined marijuana treatment admissions between 1992 and 2002 and found that between these years [1992 and 2002] the rate of substance abuse treatment admissions reporting marijuana as their primary substance of abuse3 per 100,000 population increased 162 percent. Similarly, the proportion of marijuana admissions increased from 6 percent of all admissions in 1992 to 15 percent of all admissions reported to the Treatment Episode Data Set (TEDS) in 2002.
"During this time period, the percentage of marijuana treatment admissions that were referred from the criminal justice system increased from 48 percent of all marijuana admissions in 1992 to 58 percent of all marijuana admissions in 2002."

"Differences in Marijuana Admissions Based on Source of Referral: 2002," The DASIS Report (Rockville, MD: Substance Abuse and Mental Health Services Administration, Office of Applied Studies, June 5, 2005), pp. 1-2.
http://drugwarfacts.org...

29. Substance Use Treatment Capacity and Utilization in the US, 2012

Available Treatment Capacity and Services Offered

"Facilities were asked to report the number of residential (non-hospital) and hospital inpatient beds designated for substance abuse treatment. Utilization rates were calculated by dividing the number of residential (non-hospital) or hospital inpatient clients by the number of residential (non-hospital) or hospital inpatient designated beds. Because substance abuse treatment clients may also occupy non-designated beds, utilization rates could be more than 100 percent.
"• Table 4.6. Some 2,401 facilities (23 percent) reported outpatient operational capacity under 80 percent, 3,628 facilities (34 percent) reported outpatient operational capacity between 80 and 94 percent, 3,818 facilities (36 percent) reported outpatient operational capacity between 95 and 105 percent and 727 facilities (7 percent) reported operational capacity above 105 percent.
"• Table 4.7. Some 3,281 facilities reported having 107,888 residential (non-hospital) beds designated for substance abuse treatment on March 30, 2012. The utilization rate11 was 96 percent, and ranged from 86 percent in facilities operated by local governments to 112 percent in facilities operated by tribal governments.
"• Table 4.8. Some 731 facilities reported having 11,280 hospital inpatient beds designated for substance abuse treatment on March 30, 2012. The utilization rate12 was 111 percent, and ranged from 79 percent in facilities operated by the state government to 2,000 percent in facilities operated by tribal governments. By facility focus, utilization rates ranged from 88 percent in facilities primarily focused on general health care to 165 percent in facilities focused on mental health services.
"• Tables 4.7 and 4.8 and Figure 7 show the distribution of facility-level utilization rates for residential (non-hospital) beds and for hospital inpatient beds. Facilities with residential (non-hospital) beds had generally higher utilization rates than facilities with hospital inpatient beds. Forty-eight percent of facilities with residential (non-hospital) beds had utilization rates of 91 to 100 percent and 10 percent had utilization rates above 100 percent. Twenty-nine percent of facilities with hospital inpatient beds had utilization rates of 91 to 100 percent while 16 percent had utilization rates above 100 percent."

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, pp. 23-24.
http://www.samhsa.gov/data/DAS...

30. Availability of Treatment for Opioid Dependence and the "Treatment Gap"

"Nationally, in 2012, the rate of opioid abuse or dependence was 891.8 per 100,000 people aged 12 years or older compared with national rates of maximum potential buprenorphine treatment capacity and patients receiving methadone in OTPs of, respectively, 420.3 and 119.9. Among states and the District of Columbia, 96% had opioid abuse or dependence rates higher than their buprenorphine treatment capacity rates; 37% had a gap of at least 5 per 1000 people. Thirty-eight states (77.6%) reported at least 75% of their OTPs were operating at 80% capacity or more."

Christopher M. Jones, Melinda Campopiano, Grant Baldwin, and Elinore McCance-Katz. National and State Treatment Need and Capacity for Opioid Agonist Medication-Assisted Treatment. American Journal of Public Health: August 2015, Vol. 105, No. 8, pp. e55-e63.
doi: 10.2105/AJPH.2015.302664
aphapublications.org/...

31. Treatment Facilities in the US Offering Programs or Groups for Women and Other Specific Client Types, 2012

"Facilities were asked about the provision of treatment programs or groups specially designed for specific client types. Overall, 82 percent of facilities offered at least one special program or group to serve a specific client type."

Proportion of Facilities Providing Special Programs or Groups
Clients with Co-Occurring Mental and Substance Abuse Disorders 37%
Adult Women 31%
Persons Arrested for DUI or DWI 29%
Adolescents 28%
Adult Men 25%
Other Criminal Justice System Clients1 23%
Persons Who Have Experienced Trauma2 22%
Pregnant or Postpartum Women 12%
Persons with HIV or AIDS 8%
Veterans 7%
Seniors or Older Adults 7%
Lesbian, Gay, Bisexual, Transgender, or Questioning (LGBTQ) Clients 6%
Active Duty Military 4%
Military Families 4%

1: Facilities treating incarcerated persons only were excluded from this report.
2: Persons who have experienced trauma, active duty military, and the military families categories appeared for the first time in the 2012 questionnaire.

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, p. 26.
http://www.samhsa.gov/data/DAS...

32. Ancillary Services Offered by Treatment Facilities in the US, 2012

Percentage of All Substance Abuse Treatment Facilities in the US Offering Various Ancillary Services, 2012
Ancillary Service Percent
Total 99.4
Substance Abuse Education 96.3
Case Management Services 80.2
Social Skills Development 73.6
Mental Health Services 62.0
HIV or AIDS Education, Counseling, or Support 58.0
Assistance with Obtaining Social Services 56.7
Health Education other than HIV/AIDS or Hepatitis 53.3
Mentoring/Peer Support 51.8
Assistance in Locating Housing for Clients 49.2
Self-help Groups 46.7
Hepatitis Education, Counseling, or Support 45.9
Transportation Assistance to Treatment 40.9
Domestic Violence Services 39.8
Smoking Cessation Counseling 39.0
Employment Counseling or Training for Clients 37.3
Early Intervention for HIV 26.7
Child Care for Clients' Children 7.3
Acupuncture 4.4
Residential Beds for Clients' Children 3.7

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, Table 4.9, p. 57.
http://www.samhsa.gov/data/DAS...

33. Payment Options by Treatment Facility Type, 2012

"Facilities were asked to indicate whether or not they accepted specified types of payment or insurance for substance abuse treatment. They were also asked about the use of a sliding fee scale and if they offered treatment at no charge to clients who could not pay.
"• The proportions of all facilities reporting acceptance of specific payment options were:
"  • Cash or self-payment  90 percent
"  • Private health insurance  65 percent
"  • Medicaid  58 percent
"  • State-financed health insurance  40 percent
"  • Medicare  33 percent
"  • Federal military insurance  33 percent
"• Facilities operated by federal and tribal governments were least likely to accept cash or self-payment (41 and 42 percent, respectively). Private for-profit and federal government-operated facilities were less likely to accept Medicare, Medicaid, or state-financed health insurance than were facilities operated by private non-profits and state, local, or tribal governments.
"• Acceptance of Access to Recovery vouchers was reported in 35 states or jurisdictions. The proportion of facilities accepting Access to Recovery vouchers ranged from 2 percent in Utah to 74 percent in Idaho [Table 6.19b].16
"• Use of a sliding fee scale was reported by 62 percent of all facilities, ranging from 18 percent of facilities operated by the federal government to 82 percent of facilities operated by local governments.
"• Facilities operated by tribal governments were the most likely to accept IHS/63817 contract care funds (70 percent).
"• Treatment at no charge for persons who cannot afford to pay was offered by 50 percent of all facilities, ranging from 21 percent of private for-profit facilities to 84 percent of facilities operated by tribal governments."

Substance Abuse and Mental Health Services Administration, National Survey of Substance Abuse Treatment Services (N-SSATS): 2012. Data on Substance Abuse Treatment Facilities. BHSIS Series S-66, HHS Publication No. (SMA) 14-4809. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2013, pp. 29-30.
http://www.samhsa.gov/data/DAS...

34. Ancillary Services Provided by Treatment Facilities, 2007

"One or more of the 17 specified ancillary services were provided by 99 percent of all facilities (Table 1). Ancillary services provided by more than half of all facilities included substance abuse education (94 percent); case management services (76 percent); social skills development (66 percent); HIV or AIDS education, counseling, or support (56 percent); mental health services (54 percent); and assistance with obtaining social services (52 percent)."

Substance Abuse and Mental Health Services Administration, Office of Applied Studies. (September 10, 2009). The N-SSATS Report: Services Provided by Substance Abuse Treatment Facilities in the United States. Rockville, MD. p. 3.
http://www.samhsa.gov/data/2k9...

35. Travel Distance as a Barrier to Treatment Access and Utilization in the US

Barriers to Treatment Access

"Increasing evidence suggests that distance, which can impact travel times to outpatient treatment settings, can have a significant effect on OSAT service utilization. Fortney et al. [22] studied 106 clients receiving treatment for depression and found that increased travel time from providers was significantly associated with making fewer visits and a greater likelihood of receiving less effective care [22]. Similarly, Beardsley et al. [21] focused on the distance traveled by 1,735 clients to various outpatient treatment programs in an urban setting. They found that distance is strongly correlated with treatment completion and higher retention rates; specifically, clients who traveled less than one mile (less than 1.6 kilometers) were more likely to complete treatment than those who traveled farther [21]."

Guerrero, Erick G., et al., "Availability of Substance Abuse Treatment Services in Spanish: A GIS Analysis of Latino Communities in Los Angeles County, California," Substance Abuse Treatment, Prevention, and Policy (2011), 6:21.
http://www.ncbi.nlm.nih.gov/pu...
http://www.ncbi.nlm.nih.gov/pm...

36. Lack of Availability of Spanish-Language Treatment Services in the US

"Using a multi-method approach, we identified specific areas with limited availability of OSAT [Outpatient Substance Abuse Treatment] services in Spanish in the county with the largest population of Spanish-speaking Latinos in the United States. While most communities have access to services in Spanish, the northeast area of the county – representing SPA 3 with cities such as Rowland-Hacienda Heights, West Covina, La Puente, Alhambra, El Monte, and Rosemead – reported the greatest linear distance to treatment facilities offering services in Spanish. Maps of these Latino communities, which surround cold spots E and G, show the significant scarcity of general and Spanish-speaking providers. This is a geographic region that is home to almost one fifth (18%) of the county’s Latino residents, and where 70% of Latino residents report speaking primarily Spanish in the home [39].
"It is highly likely that the disparity between the need for Spanish-language substance abuse treatment and
geographical accessibility to Spanish OSAT services in certain regions of the County (e.g., SPA 3) is greater than what is presented in this study. U.S. Census data from 2000 yield conservative Latino population estimates in L.A. County, and although final 2010 Census estimates are not yet fully available, it is evident that the Latino population has grown rapidly in the last decade. Possibly the most interesting finding extracted from these maps is that the areas traditionally known to have high Latino populations (the three highlighted SPAs–4, 6, and 7–in Figure 1) may be relatively well served. It is the more fragmented, but expanding, communities that may not be accurately depicted in data from 2000 (i.e., SPA 3) wherein the greatest need for language capacity building exists. Considering that Latinos are the fastest-growing ethnic minority group [6], the unmet service need found in this study is likely to be more pronounced in population data from 2010, as preliminary information indicates significant growth in SPA 3.
When combined with the oversimplification of linear distance and considering that the most recent data are
the facility locations, our findings suggest that an inaccessibility problem exists for neighborhoods in these areas. It is expected that there will always be neighborhoods that are poorly served due to isolation. However, these results, especially if overlaid with other socioeconomic measures, will make for an interesting comparison between 2000 and 2010 census population distributions in future studies."

Guerrero, Erick G., et al., "Availability of Substance Abuse Treatment Services in Spanish: A GIS Analysis of Latino Communities in Los Angeles County, California," Substance Abuse Treatment, Prevention, and Policy (2011), 6:21.
http://www.ncbi.nlm.nih.gov/pu...
http://www.ncbi.nlm.nih.gov/pm...

37. Language, Socio-economic, and Other Barriers to Treatment Access and Utilization in the US

"The relationship between access to responsive services and treatment completion rates among Latinos points to a serious need for greater geographic proximity to Spanish-language services for this population. Although testing treatment outcomes is not the focus of this paper, it should be noted that studies suggest that linguistic preferences significantly impact the treatment process among Latinos, indirectly contributing to treatment outcomes [5,19,25,26]. In particular, engaging clients in their native language during the intake process increases treatment retention and compliance, which are highly associated with treatment completion and improvements in posttreatment drug use. Similarly, studies have found that limited availability of bilingual treatment services is highly associated with high attrition rates from substance abuse treatment among Latinos when compared to other racial/ethnic groups [27-30].
"Highlighting potential barriers to health care access, such as distance to treatment, is of importance as past studies indicate that treatment completion rates are affected by transportation issues related to distance to outpatient treatment sources [31]. In particular, low-income individuals with significant transportation and communication challenges would be at a considerable disadvantage in terms of addressing their substance abuse issues."

Guerrero, Erick G., et al., "Availability of Substance Abuse Treatment Services in Spanish: A GIS Analysis of Latino Communities in Los Angeles County, California," Substance Abuse Treatment, Prevention, and Policy (2011), 6:21.
http://www.ncbi.nlm.nih.gov/pu...
http://www.ncbi.nlm.nih.gov/pm...

38. Insurance Coverage

"In contrast to other chronic diseases, funding for addiction treatment disproportionately comes from government sources. More than three quarters—77 percent—of treatment costs are paid by federal, state and local governments, including Medicaid and Medicare.
"Private insurance covers only 10 percent of addiction treatment costs, with out-of-pocket expenditures and other private funding making up the remaining percentage. In contrast, private insurance pays for approximately 37 percent of general medical costs. The passage of federal parity and health care reform legislation should help address this imbalance in the future.
"On an individual level, nearly half of those receiving treatment reported using their own money to pay for their care, and 34.8 percent report using private health insurance."

"Defining the Addiction Treatment Gap" Open Society Foundations (New York, NY: Open Society Foundations, November 2010), p. 5.
http://www.opensocietyfoundati...

39. Women Under-Represented in Substance Use Treatment Globally

"To be equally represented in treatment, the ratio of males to females in treatment should be similar to the ratio of males to females in problem drug use. Using past-month prevalence as a proxy for problematic use,24 gender-disaggregated data from EMCDDA on past-month prevalence and outpatient clients in treatment suggest that in most countries in Europe females could be underrepresented in treatment for the problematic use of cannabis, cocaine and amphetamines (see figure 5). There are few studies that analyse gender differences in the accessibility of treatment services; however, the ratio of males and females reported in treatment in Europe was 4:1 — higher than the ratio between male and female drug users.25 In many developing countries, there are limited services for the treatment and care of female drug users and the stigma associated with being a female drug user can make accessibility to treatment even more difficult. In Afghanistan, for instance, 10 per cent of all estimated drug users have access to treatment services,26 whereas only 4 per cent of female drug users and their partners have access to treatment services and interventions."

UN Office on Drugs and Crime, World Drug Report 2012 (United Nations publication, Sales No. E.12.XI.1), p. 16.
https://www.unodc.org/document...

40. Treatment Effectiveness

Effectiveness

"The overriding finding from this study is that treatment is associated with a reduction in harmful behaviours that are associated with problem drug use. The majority of treatment seekers received care-coordinated treatment, expressed satisfaction with their care, were retained in treatment beyond three months, reported significant and substantial reductions in drug use and offending, and improvements in mental well-being and social functioning."

Andrew Jones, et al., "Research Report 24: The Drug Treatment Outcomes Research Study (DTORS): Final Outcomes Report" (London, England: UK Government, Home Office Ministry, Research, Development & Statistics Directorate, December 2009), p. 14.
http://socialwelfare.bl.uk/sub...
http://socialwelfare.bl.uk/sub...

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