The 2010 evaluation for all Dutch patients admitted between 7th May 2007 and 16th December 2008.
Summary of findings
- One patient with a primary gambling addiction, 89 drug and 66 alcohol-dependent patients from the Netherlands entered Castle Craig Hospital between 7th May 2007 to 16th December 2008 and stayed in treatment for more than 1 day.
- Most patients were alcohol or cocaine addicts.
- Patients were generally quite dysfunctional at intake. The average intake CISS total score of the 156 patients was 11.0 and their greatest problems were with drug or alcohol use, lack of support, psychological problems, lack of occupation, and poor health.
- Drug dependent patients tended to have greater problems with social functioning, viral risk, and criminality.
- Alcohol dependent patients tended to have greater problems with health and working relationships.
- Patients were generally more dysfunctional than those attending outpatient alcohol or drug services (based on the CISS comparison scores see Appendix).
- The patients’ average wait between referral to treatment entry was 7.3 weeks.
62% of patients completed treatment, 32% of patients prematurely self-discharged against medical advice, 6% of patients were prematurely discharged for rule violations, and one patient was prematurely discharged on medical grounds.
- The average treatment duration for patients’ taking a planned discharge was 21 weeks, and the average treatment duration for prematurely discharged patients was 9 weeks.
- Premature treatment discharge was a little more likely among the drug users.
- Follow-ups were successfully completed on 113 of the 156 patients (72.4% response rate).
- Thirty-nine patients could not be contacted and four patients had died.
- The average follow-up period was 67 weeks.
- 92% of followed-up patients improved, 8% remained the same, none got worse.
- 63% of patients completing treatment did well, whereas only 35% of patients taking an unplanned discharge (for whatever reason) had a good outcome.
- A good outcome was predicted by
- Shorter time is taken to enter treatment
- Completion of treatment
- Longer treatment duration
- Fewer social functioning problems
- Fewer viral risk behaviour problems
- Fewer occupational problems
- Less criminal involvement
- Fewer compliance problems
- The average intake CISS score of the 113 followed-up patients was 10.6 and the average follow-up CISS score was 4 indicating a highly significant improvement in general functioning.
- Reductions in drug/alcohol use at follow-up were accompanied by improvements in all other CISS domains.
- Even those who were not totally abstinent at follow-up appeared to have benefited from their experience in treatment, probably by gaining a period of respite during which to recover from the consequences of their excessive drinking or drug use.
- The following success rates are conservatively based by including all 156 patients on the assumption that the 43 patients not followed-up (response rate = 72.4%) showed no improvement or otherwise had poor outcomes.
- Being totally abstinent from all drugs or alcohol at follow-up 46%
- Achieving low problem severity at follow-up (CISS < 6, see appendix) 52%
- Showing any reduction in measured levels of dysfunction 69%
In reality, the success rates are most likely to be higher because some of the missing patients would not have been contactable due to having recovered and being in full time occupation.
- The following success rates are thus more liberally based by including the 4 patients that died but not including the other 39 patients that could not be contacted for follow-up (n = 117).
- Being totally abstinent from all drugs or alcohol at follow-up 61%
- Achieving low problem severity at follow-up (CISS < 6, see appendix) 69%
- Showing any reduction in measured levels of dysfunction 89%