Short-term Outcomes for the Treatment of Heroin Dependence: Findings From the Australian Treatment Outcome Study (ATOS)

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To examine drug use, crime, physical and mental health at 3 months postentry to treatment for heroin dependence.


Longitudinal cohort study.


Sydney, Melbourne, and Adelaide, Australia.


Seven hundred forty-five individuals recruited on entry to treatment for heroin dependence in the 3 main treatment modalities (methadone/buprenorphine maintenance therapy; detoxification; residential rehabilitation), and 80 heroin users who were not seeking treatment at baseline.


Structured questionnaires were used to measure drug use, crime, psychopathology, and physical health. At 3 months 10% of the cohort were randomly selected and provided a hair sample as a biologic measure of heroin use for the month preceding interview.


A 3-month follow-up rate of 88% (n=728) was achieved. There were substantial reductions in heroin use, polydrug use, injection-related risk-taking, heroin overdose, and criminal activity, as well as improvements in physical and mental health. Improvements were less marked among the nontreatment group. There was strong concordance between the cohort's self-reported heroin use and hair analysis results. Positive outcomes tended to be associated with a greater cumulative number of treatment days, and fewer treatment episodes.


Treatment works in the short term. Greater treatment exposure was related to improvements across a range of outcomes.

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