Joint versus separate inpatient rehabilitation treatment for patients with alcohol use disorder or drug use disorder: an observational study

Abstract

Stefan Bender,1 Michael Specka,2 Angela Buchholz,3 Stefan Hölscher,2 Fred Rist,4 Thomas W Heinz,5,6 Fabrizio Schifano,7 Norbert Scherbaum2 1Psychiatry, Psychotherapy and Psychosomatics, LWL-Hospital Marsberg, Marsberg, Germany; 2Department of Addictive Behaviour and Addiction Medicine, LVR-Hospital Essen, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany; 3Institute of Medical Psychology; University Hospital Hamburg-Eppendorf, Hamburg, Germany; 4Insitute for Psychology, University of Münster, Münster, Germany; 5Psychiatry, Psychotherapy and Psychosomatics, LWL-Hospital Warstein, Warstein, Germany; 6Addiction Hospital St. Vitus, Visbek, Germany; 7Psychopharmacology, Drug Misuse and Novel Psychoactive Substances Research Unit, School of Life and Medical Sciences, University of Hertfordshire, Hatfield, Hertfordshire, UK Background: In many national treatment systems, patients with alcohol use disorders (AUD) and those with drug use disorders (DUD) are treated separately, while other systems provide joint treatment for both kinds of substance use disorders (SUDs). Regarding long-term rehabilitation treatment of DUD and AUD patients, there is however a lack of empirical studies on the comparison between a separate versus joint treatment modality. Methods: Data were gathered from 2 rehabilitation units located in small towns from the same German region. One unit provided treatment to a mixed group of AUD and DUD patients, while the other unit treated the 2 groups separately. Staffing, funding, and treatment programs were otherwise similar between facilities. Data were gathered from standardized routine documentation and standardized interviews. In order to understand correlates of premature treatment termination, a logistic regression analysis was performed, with treatment modality and type of SUD as main predictors, and a range of patient characteristics as covariates. Results: Patients (N=319) were diagnosed with AUD (48%), DUD (34%), or AUD plus DUD (18%). Patients in joint treatment showed a higher prevalence of lapses during treatment than those in separate treatment (26% versus 12%; p=0.009), but there was no significant difference in the prevalence of premature terminations (38% versus 44%, p=0.26). Treatment modality and interaction between modality and type of SUD was not significantly associated with premature termination. Joint treatment completers showed higher satisfaction with treatment than separate treatment completers (p<0.001). Conclusion: We found no evidence here for a difference between treatment modalities in terms of premature termination rate. Satisfaction level was higher in those who completed joint treatment compared to separate treatment. Keywords: alcohol use disorder, drug use disorder, rehabilitation treatment, inpatient treatment, joint treatment, long-term treatment

Keywords

• alcohol use disorder
• drug use disorder
• rehabilitation treatment
• inpatient treatment
• joint treatment
• long-term treatment