SERVICES RESEARCH OUTREACH SURVEY(SROS) sros8.htm

The Services Research Outcomes Study (SROS) validates repeated study findings that drug treatment has practical and tangible benefits to drug users and society. The reduction in crime alone produces benefits to society that outweigh the investment in treatment.

While the overall use of illicit drugs dropped after substance abuse treatment, some distinct differences emerged in the rate of change among treatment subgroups. For overall drug use and for each of the most frequently used drugs (marijuana, cocaine, crack, and heroin), the decrease in post-treatment usage was larger among females than among males. The one exception to the overall decrease in drug use following treatment was for those who were adolescent when discharged from treatment. Following treatment, adolescents increased their use of alcohol by 13 percent and the use of crack by 202 percent, albeit from a low pre-treatment base of five percent. Specific reasons for the difficulties in treating adolescents remain unclear. Consequently, this treatment subgroup poses an ongoing challenge for addiction researchers and those who work with adolescent substance abusers.

The study showed that length of stay in drug treatment was associated with decreases in drug use. Clients who stayed in treatment the longest were most likely to reduce or eliminate their pre-treatment drug use. This finding was consistent for all drugs except crack.

The link between substance abuse and criminal behavior is well established, and the SROS findings confirm the results of previous studies showing that treatment for substance abuse can significantly reduce crime. Most criminal activity, including income-producing crimes (breaking and entering, drug sales, and prostitution) and violent and disorderly offenses (driving under the influence and weapons use) declined by between 23 and 38 percent after drug treatment. However, there was no statistically significant difference in crimes of rape, homicide, robbery, and arson before and after treatment, though these numbers were already low in the client treatment population before treatment.

The study distinguished between criminal activity—as reported by the study participants—and arrests for criminal activity. While overall rates of most criminal behavior dropped, clients reported that their arrests declined by a smaller rate (17 percent) than did their criminal behavior. Indeed, the rate of incarceration increased by 17 percent, and probation and parole violations rose by 26 percent. This is not surprising if the treatment episode was associated with criminal activity requiring sustained supervision by the criminal justice system, including increased opportunities for arrest and parole violation.

Sex and Age. The percent change in specific criminal activities before and after treatment differed somewhat by sex, but they showed no unifying pattern of consistent differences.

Older age groups were much more likely to reduce their post-treatment criminal activities than were younger groups. The SROS revealed a dramatic difference in criminal behavior between the youngest and oldest age groups: the rate of driving under the influence (DUI) and driving while intoxicated (DWI) increased for youth under 18 years old after treatment; and youth under age 18 increased selling drugs after treatment. Age groups over 30 decreased their criminal behavior in every area.

The SROS also showed improved lifestyle characteristics in child custody, housing, employment, depression and suicide attempts following treatment: a 30 percent decline in loss of child custody; 40 percent drop in time spent on the street; 20 percent reduction in being assaulted; and a 43 percent decline in suicide attempts.

Employment. There was no appreciable change in the rate of full-time employment for clients discharged from treatment. Moreover, clients were less likely to be employed in a full-time job after treatment than before if they:

Because drug treatment does not necessarily include job training, improved employment should not be expected.

From a sample of 1,799 (71.4% male and 28.6% female) interviewed clients, it is possible to estimate what is happening in the overall U.S. population of treatment clients. This is done by weighting each respondent according to their likelihood of being in the sample; the likelihood of their program being selected for the study; and the likelihood of their being selected from their program. The details of the weighting procedures are included in the full report. Examples of national estimates of the effects of drug treatment for the 1990 discharged client population of 976,012 make a strong case for the effectiveness of drug treatment interventions. In the five years after treatment, there were an estimated:

•165,000 fewer driving while intoxicated/ 131,000 fewer driving under the influence cases.

About nine percent of the entire client sample died during the five-year post-treatment period. After controlling for age, sex, and race, a comparison of these numbers to the annual death rate in the U.S. population shows that:

•White males discharged from treatment had roughly eight times as many deaths as expected (108 deaths, rather than the expected 13);

• White females discharged from treatment had nearly 18 times as many deaths as expected (35 deaths, rather than the expected two);

•Black males discharged from treatment had about five times as many deaths as expected (67 deaths, rather than the expected 13);

•Black females discharged from treatment had seven times as many deaths as expected (14 deaths, rather than the expected two).

SAMHSA, an agency in the Department of Health and Human Services, is the Federal Government's lead agency for improving the quality and availability of substance abuse prevention, addiction treatment, and mental health services in the United States.

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