Rehab benefit for meth abuse not crystal clear

Community-based residential rehabilitation significantly reduces methamphetamine use compared with detoxification, but the effect only lasts for up to a year, researchers report.

Rebecca McKetin (The Australian National University, Canberra) and co-authors found that detoxification did not reduce methamphetamine use in dependent users compared with a group of nondependent users (quasi-control group).

On the other hand, compared with the quasi-control and detoxification groups combined, residential rehabilitation produced large reductions in the frequency of methamphetamine use at 3 months (odds ratio [OR]=0.23).

However, there was a marked attenuation of this effect at 1 year (OR=0.62) and 3 years (OR=0.71).

The attenuation at 1 and 3 years with residential rehabilitation use brought methamphetamine use down to the level that would be expected if participants had not received treatment at all or had only received detoxification, concede McKetin et al.

The greatest change in methamphetamine use was seen for abstinence, with 34% more participants in the residential rehabilitation group reporting no use at the 3-month follow up, dropping to 9% and 6% at 1- and 3-year follow ups, respectively.

However, it is important to note that these results may not necessarily apply to locations where methamphetamine use patterns and drug treatment differ from those seen in Australia, the authors caution.

"These findings highlight the chronic relapsing nature of methamphetamine dependence and the need for a treatment approach with a more sustained impact," remark McKetin and team.

They say that although residential rehabilitation facilities provide a structured drug-free environment to initiate abstinence, the approach may not address factors that are likely to relapse once the individual re-enters the community.

These factors include drug cravings, socializing and living with drug users, and conflict and stress.

Furthermore, "while existing research shows that residential rehabilitation is cost-effective, the lack of control groups in previous studies means that they may overestimate the benefits of treatment," McKetin and team point out.

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