DRUG ABUSE REPORTING PROGRAM (DARP)

The Drug Abuse Reporting Program began in 1969 as a comprehensive data system that included intake and during-treatment information on individuals entering drug treatment programs funded by the U.S. government. Over time, it was the basis for carrying out the first national evaluation study of community-based treatment programs. It was conducted at Texas Christian University over a period of twenty years and included four distinct phases of research: (1) describing major treatment modalities and the characteristics of drug abusers entering them in the early 1970s; (2) describing during-treatment performance measures and how they related to differences in treatments and clients; (3) describing post-treatment outcomes and how they related to differences in treatments and clients; and (4) describing important elements of long-term addiction careers.

The DARP data system contained records on almost 44,000 admissions to fifty-two federally supported treatment agencies from 1969 to 1973—the years during which the current community treatment delivery system first emerged in the United States. The study population consisted of clients from major Treatment modalities—Methadone Maintenance Programs, Therapeu-Tic Community, outpatient drug-free, and Detoxification—as well as a comparison intake-only group.

THE EFFECTIVENESS OF DRUG-ABUSE TREATMENT

Initial research in this 20-year project focused on ways of measuring characteristics of treatments, clients, and behavioral outcomes (see Sells & Associates, 1975). It was found that drug use and criminal activities decreased significantly during treatment, including outpatient as well as residential programs. More important, the effects continued after treatment was ended. A sample of 6,402 clients located across the United States were selected for follow-up an average of three years after leaving DARP treatment (and 83% were located). Methadone maintenance, therapeutic communities, and outpatient drug-free programs were associated with more favorable outcomes among opioid addicts than outpatient detoxification and intake-only comparison groups; however, only clients who remained in treatment three months or longer showed significant improvements after treatment. Numerous studies of these data helped establish that treatment "works" and that the longer clients stay in treatment, the better they function after treatment (see Simpson & Sells, 1982).

LONG-TERM OPIOID ADDICTION CAREERS

To study long-term addiction careers, a sample of 697 daily Opioid (primarily Heroin) users were followed up with again, at twelve years after entering treatment (and 80% were located). It was found that about 25 percent of the sample was still addicted to daily opioid use in year twelve. Length of addiction (defined as the time between first and last daily opioid use) ranged from one to thirty-four years. Of the total sample, 50 percent was addicted nine-and-a-half years or longer, yet 59 percent never had a period of continuous daily use that exceeded two years. Only 27 percent reported continuous addiction periods that lasted more than three years.

Three-fourths of the addicts studied had experienced at least one "relapse" to daily opioid use after they had temporarily quit. Among those who had ever temporarily quit daily opioid use at least once, 85 percent had done so while in a drug-abuse treatment, 78 percent had quit while in a jail or prison, 69 percent had temporarily quit "on their own" (without treatment), and 41 percent had quit while in a hospital for medical treatment. The most frequent reasons cited for quitting addiction the last time involved psychological and emotional problems. Ex-addicts reported they had "become tired of the hustle" (rated as being important by 83% of the sample) and needed a change after "hitting bottom" (considered important by 80%). Other reasons cited as being important were "personal or special" events such as a marriage or the death of a friend (64%), fear of being sent to jail (56%), and the need to meet family responsibilities (54%) (See Simpson & Sells, 1990, for further details).

SUMMARY

The DARP findings have been widely used to support continued public funding of drug-abuse treatments and to influence federal drug policy in the United States. Other similar national treatment evaluation studies have been planned and undertaken at the beginning of each decade since the 1970s. Current research efforts focus on increasing understanding of the particular elements of treatment that are most effective and how they can be improved.

(See also: Drug Abuse Treatment Outcome Studies ; Narcotic Addict Rehabilitation Act )

BIBLIOGRAPHY

Sells, S. B., et al. (1975). The DARP research program and data system. American Journal of Drug and Alcohol Abuse, 2, 1-136.

Simpson, D.D., & Sells, S. B. (1990). Opioid addiction and treatment: A 12-year follow-up. Malabar, FL: Krieger.

Simpson, D.D., & Sells, S. B. (1982). Effectiveness of treatment for drug abuse: An overview of the DARP research program. Advances in Alcohol and Substance Abuse, 2 (1), 7-29.

Dwayne Simpson