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Sells, S. B., Demaree, R. G., Simpson, D. D., & Joe, G. W. (1978).   Evaluation of present treatment modalities: Research with DARP admissions, 1969-1973.   Annals of the New York Academy of Sciences, 311, 270-281.

Abstract:   The results of this national evaluation of treatment effectiveness clearly indicated that post-DARP outcomes were generally favorable for the treatment modalities MM, TC, and DF, and comparatively unfavorable for the DT and IO groups. Differences were found between MM, TC, and DF on specific criteria, but the judgment concerning which group had the “best” outcomes depends on subjective factors and is not entirely an empirical matter. The goals and philosophies of these treatment modalities are substantially different in many respects, and decisions concerning their relative success are dependent on the ideological positions and values of the reader. Using the most rigid criteria, including drug abstinence and no return to drug treatment, the TC group shows the most favorable outcomes. On the other hand, these criteria are not universally accepted among advocates of methadone maintenance treatment. There are respected professionals in the field who do not view return to drug treatment and occasional drug use with the same negative connotations. The DT and IO groups were clearly identified as having the poorest outcomes.

  
Savage, L. J., & Simpson, D. D. (1978).   Illicit use and return to treatment: Follow-up study of treatment admissions to DARP during 1969-1971.   American Journal of Drug and Alcohol Abuse, 5(1), 23-38.

Abstract:   The present study was based on follow-up data on 1,409 persons interviewed 4 to 6 years after admission to drug treatments in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The focus of this study was on illicit drug use of former DARP clients, taking into account if and when they reentered drug treatment after termination of DARP treatment. The results showed that a significant drop in opioid and nonopioid (but not marihuana) drug use generally occurred upon entry into other, post-DARP treatments, and that these beneficial effects of treatment tended to continue beyond the end of treatment. Overall, 42% of the sample had not further drug treatment during the first 3 years after DARP, and almost half (42%) of this group used no opioid or nonopioid drugs at all during this time. Comparisons between DARP treatment groups also indicated that therapeutic community clients had the lowest rate of return to post-DARP treatments.

   
Simpson, D. D., & Lloyd, M. R. (1978).   Alcohol and illicit drug use: Follow-up study of treatment admissions to DARP during 1969-1971.   American Journal of Drug and Alcohol Abuse, 5(1), 1-22.

Abstract:   The present study was based on follow-up data on 1,409 persons interviewed 4 to 6 years after admission to drug treatment in the Drug Abuse Reporting Program (DARP). The admissions to DARP occurred in 1969-1971, and for most persons the follow-up data included 3 or more years after termination of DARP treatment. The study focused on variations in alcohol consumption associated with post-DARP drug use and treatment status. The results indicated that use of alcohol and non-opioid drugs (particularly marijuana) tended to be correlated, but that this was not true of opioid drugs. For a small segment of the sample, evidence suggested that substitution of use may have occurred between alcohol and opioid drugs. Also, persons with post-DARP drug treatment tended to use less alcohol than persons without treatment. Interpretations and implications of these findings are discussed.
   

1979

Simpson, D. D., Savage, J., & Lloyd, M. R. (1979).   Follow-up evaluation of treatment of drug abuse during 1969 to 1972.   Archives of General Psychiatry, 36, 772-780.

Abstract:   A sample of 3,131 persons from approximately 25,000 admitted to drug abuse treatment programs in the Drug Abuse Reporting Program during 1969-1972 were followed up in 1975-1976. Treatment groups included methadone hydrochloride maintenance, therapeutic community, outpatient drug free, outpatient detoxification, and a comparison group that completed intake but did not enter treatment. Outcome criterion measures (drug use, employment, criminality, and treatment readmissions) based on the first year after treatment were more favorable in the methadone maintenance, therapeutic community, and outpatient drug-free groups than in the outpatient detoxification and intake-only groups. Evaluation of differential outcomes and their relationships with pretreatment and during-treatment measures within each group indicated that pretreatment criminal history, during-treatment performance, and length of time in treatment were significantly related to posttreatment outcomes.

   
Simpson, D. D. (1979). The relation of time spent in drug abuse treatment to posttreatment outcome. American Journal of Psychiatry, 136(11), 1449-1453.

Abstract:  The author examined follow-up outcomes in the first year after treatment in relation to time spent in treatment in the Drug Abuse Reporting Program. Follow-up interviews were completed with more than 3,000 people admitted to drug abuse treatment during 1969-1972, including clients treated with methadone maintenance, therapeutic communities, outpatient drug-free programs, and outpatient detoxification, as well as a group who completed intake procedures but did not return for treatment. Longer time in treatment was related to better posttreatment outcome, but clients who spent less than 3 months in treatment were not significantly different from the detoxification-only group or the intake-only group.

 
Sells, S. B., & Simpson, D. D. (1979).   On the effectiveness of treatment for drug abuse: Evidence from the DARP research programme in the United States. Bulletin on Narcotics, 31(1), 1-11.

Abstract:   The combined evidence of differential performance after DARP leaves little doubt that the MM, TC, and DF programmes were of major significance in the rehabilitation of drug users. Limitations of the research design do not permit the causal demonstration of specific treatment effects, but the data presented suggest that significant, consistent, and specifiable changes occurred in natural treatment situations that did not occur in other treatment or non-treatment situations. In that sense, the DARP studies described show that “treatment works.”

   
Sells, S. B., & Simpson, D. D. (1979). Implications for evaluation of drug dependency treatment based on data provided by a management information system. Addictive Diseases: An International Journal, 3(4), 533-554.

Abstract:   Favorable scores on a general index of during-treatment performance and longer tenure in treatment were predictive of favorable post-DARP outcomes for DARP MM, TC, and DF clients (these during-treatment variables were not applicable for the DT and IO groups). Scores representing low background criminal history were also related to favorable overall outcomes in every group except TC. Even in TC, they were related to the specific outcome measure representing jail. Thus, criterion performance during DARP treatment – especially the general index of deviance in treatment and length of time in treatment, and a background index of criminal history – were most consistently related to posttreatment outcomes in the major DARP treatment modalities.

   
Sells, S. B., & Simpson, D. D. (1979).   Evaluation of treatment outcome for youths in the Drug Abuse Reporting Program (DARP): A follow-up study.   In G. M. Beschner, & A. S. Friedman (Eds.), Youth drug abuse: Problems, issues, and treatment (pp. 571-613).   Lexington, MA: Lexington Books, D.C. Health and Company.

Abstract:   In general, the retention data for the DARP youth sample indicate that youths remained in all treatments except MM for longer periods than the total (mainly adult) DARP samples. Retention rates and percentage of treatment completions were best for the youth sample in DF, particularly for whites and the under 18 group. The follow-up results generally showed favorable outcomes 4 to 6 years after admission for all DARP treatments, particularly with respect to drug use other than marihuana and alcohol. Although average tenure in MM was appreciably longer than in the drug-free treatments, the posttreatment results for DF were best overall and those for TC were in many ways superior to those for MM in this youth sample. The DARP treatments, however, apparently failed to influence youths with respect to marihuana and alcohol and were at best only moderately successful in improving employment – although both DF and TC were superior to MM results. Comparisons on criminality were difficult because of variations in pretreatment levels between treatments, but overall the results were favorable.

   
Simpson, D. D., & Lloyd, M. R.. (1979). Client evaluations of drug abuse treatment in relation to follow-up outcomes. American Journal of Drug and Alcohol Abuse, 6(4), 397-411.

Abstract:   A national sample of drug treatment clients admitted to the Drug Abuse Treatment Program (DARP) during 1969-1972 was followed approximately 5 years after admission. Subjective evaluations of treatment were compared for clients in methadone maintenance, therapeutic community, outpatient drug-free, and outpatient detoxification treatment programs, as well as a comparison group of clients who completed intake but received no treatment. These evaluations were also analyzed in relation to client background and treatment performance measures and posttreatment outcomes. The overall evaluation of DARP treatments by former clients was generally favorable and was highest for the DARP therapeutic community. Over two-thirds of the combined treatment sample indicated satisfaction with the treatment they received and a willingness to recommend it to others. Favorable evaluation was also positively related to during-treatment performance and tenure in DARP treatment as well as to behavioral outcomes after leaving treatment.
   

1980

Sells, S. B., & Simpson, D. D. (1980).   The case for drug abuse treatment effectiveness, based on the DARP research program.   British Journal of Addiction, 75, 117-131.

Summary:   The Drug Abuse Reporting Programme (DARP) is a large-scale evaluation project focused on the effectiveness of drug abuse treatment, based on almost 44,000 clients admitted to 52 treatment centres located throughout the United States and in Puerto Rico between June 1969 and March 1973. The present paper summarizes research on post-DARP follow-up data (representing up to six years after DARP) for a sample of 3,131 persons admitted to treatment during 1969 to 1972. Treatments included methadone maintenance (MM), therapeutic community (TC), out-patient drug-free (DF), and out-patient detoxification programmes (DT); a comparison group of intake only (IO) clients with no DARP treatment was also followed up. The data showed in general that three treatments, MM, TC, and DF, led to favourable results – MM and TC for heroin and other opioid addicts, and DF for non-addicts (users of opioids less-than-daily, usually in conjunction with other non-opioid drugs and users of non-opioids only).

   
Simpson, D. D., & Savage, L. J. (1980).   Drug abuse treatment readmissions and outcomes: Three-year follow-up of DARP patients.   Archives of General Psychiatry, 37(8), 896-901.

Abstract:   Temporal patterns of drug abuse treatment reentry and other outcome measures were examined over a three-year period based on a national follow-up sample of persons admitted to treatment in the Drug Abuse Reporting Program (DARP) during 1969 to 1972. Follow-up treatment modes included methadone maintenance, residence in a therapeutic community, outpatient drug-free treatment, outpatient detoxification treatment, and a comparison group whose members completed intake only and did not return for treatment in the DARP. Treatment readmission patterns were examined in relation to outcome measures for illicit drug use, alcohol use, employment, and criminality over time. The findings showed there were reliable associations between readmission patterns and posttreatment outcomes, which suggested there were beneficial effects of drug abuse treatment.

   
Simpson, D. D., & Savage, L. J. (1980).   Treatment re-entry and outcomes of opioid addicts during a four-year follow-up after drug abuse treatment in the United States.   Bulletin on Narcotics, 32(4), 1-10.

Abstract:   Post-treatment outcome measures during a four-year follow-up period were examined in relation to readmissions to drug abuse treatment. The sample included, 1,174 opioid addicts admitted during 1972-1973 to 26 different treatment programmes throughout the United States that participated in the Drug Abuse Reporting Program (DARP). Admissions to methadone maintenance programmes, therapeutic communities, outpatient drug-free treatments, and outpatient detoxification programmes were studied, as well as a comparison group which completed admission procedures but did not return for treatment at the DARP agency. The examination of temporal patterns of treatment and outcome indicators representing drug use, criminality, and productive activities during the four-year follow-up period showed that there were beneficial effects associated with treatment.

  
Simpson, D. D., Savage, L. J., & Joe, G. W. (1980).   Treatment histories of clients treated for drug abuse.   American Journal of Drug and Alcohol Abuse, 7(2), 127-140.

Abstract:   History of drug abuse treatment was examined for clients included in a national follow-up study based on admissions to the Drug Abuse Reporting Program (DARP) during 1969-1972. Clients were sampled from DARP-methadone maintenance, therapeutic community, outpatient drug-free, and outpatient detoxification programs, as well as an intake only comparative group. Pre-DARP treatment was reported by 40% of the total sample, with detoxification being the most common. Treatments in the first three years after DARP were reported by 51%, with methadone maintenance being the most common. There was an overall trend toward methadone maintenance as the predominant treatment after DARP regardless of the type of treatment a client received in the DARP, and approximately on-third of the total sample reported no other treatments either before or after DARP.

  
Savage, L. J., & Simpson, D. D. (1980).   Posttreatment outcomes of sex and ethnic groups treated in methadone maintenance during 1969-1972.   Journal of Psychedelic Drugs, 12(1), 55-64.

Abstract:   This study evaluated changes in behavior from before to after DARP methadone maintenance treatment and compared post-DARP outcomes between sex and ethnic groups. With regard to change from the dysfunctional baseline performance levels at treatment admission, the expected significant improvements were observed in posttreatment opioid use, nonopioid use and stable employment, but significant increases were also observed in heavy alcohol use and marijuana use. The increase in alcohol use, studied in more detail by Simpson and Lloyd (1978), appeared to be related in part to substitution of alcohol for opioid drugs in a relatively small percentage of the sample. The increase in marijuana use during the post-DARP period, on the other hand, coincided with a number of legal and social changes in the United States regarding marijuana and a general increase in prevalence of use.
   
 

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