A meta-analysis of predictors of continued drug use during and after treatment for opiate addiction

Aims. Many people treated for opiate addiction continue to use drugs during and after treatment. It may be possible to improve outcomes by addressing patient characteristics that predict continued drug use. This review uses meta-analytic techniques to identify risk factors for continued drug use in patients treated for opiate abuse. Design and Measurements. A thorough search of the published literature yielded 69 studies that reported information on the bivariate association between one or mor independent variables and continued use of illicit drugs during and after treatment for opiate addiction. Findings. Most of the patient variables summarized have weak longitudinal relationships with continued drug use, although several variables display moderate longitudinal associations. Ten variables show statistically significant and longitudinally predictive relationships (average r > 0.1) with continued use, including: high level of pretreatment opiate/drug use, prior treatment for opiate addiction, no prior abstinence from opiates, abstinence from/light use of alcohol, depression, high stress, unemployment/employment problems, association with substance abusing peers, short length of treatment, and leaving treatment prior to completion. Several other variables may be potentially longitudinally predictive. Conclusions. To prevent relapse, treatment interventions should address multiple variables because no single variable strongly predicts continued drug use.