Addicts who begin using narcotics during their youth have a harder time staying off drugs than those who first take them as adults, according to a study of methadone treatment programs in a journal published by the Institute for Operations Research and the Management Sciences (INFORMS®). Long-range prospects are particularly dismal for minorities, the study confirms.
The study employed the tools of operations research to analyze lifelong drug use patterns of more than 800 narcotic addicts who received treatment at methadone maintenance clinics in central and southern California. These operations research tools utilize math modeling, including a "flexible split-hazard specification model" for differentiating addicts who relapse and those who don't.
The study, "Long-Run Abstinence After Narcotics Abuse: What Are the Odds?" was written by Marnik G. Dekimpe and Linda M. Van de Gucht, Catholic University, Leuven, Belgium, and Dominique M. Hanssens and Keiko I. Powers, Anderson Graduate School of Management, UCLA. The study was funded by grants from the National Institute on Drug Abuse. It appears in the current edition of Management Science, a publication of INFORMS.
The study lists several major recommendations, including --
- Monitor Former Addicts Longer: Because of high relapse rates, programs should
periodically monitor former drug users' abstinence, even long after treatment
has ended.
- Work Better With Youth: Because long-run abstinence is strongly dependent upon
the earliest age of drug use, the value of preventing, or at least delaying,
youngsters from using drugs is strongly confirmed.
- Target High Risk Groups: Given limited dollars for treatment, the study suggests there may be more profound results if treatment programs concentrate on high-risk groups, like youthful minority members, rather than the population at large. The study offers an improved method of identifying high-risk groups.
Age and Race Key Elements
The study focused on three groups based on age of first drug use: 16 or younger; 17-24, and 25+. The chances for abstinence are clearly higher for those who begin using drugs later in life. Addicts who first used narcotics on a daily basis at age 25 or older had a 57% lower conditional relapse probability in any given month of treatment and recovery than addicts who started at a younger age, the study shows. Daily drug abuse at a young age seriously jeopardized one's chances of remaining abstinent in the future.
The study, which focused on whites and Chicanos, confirmed that the odds of remaining abstinent in the long run are less favorable for Chicanos than for whites. Chicano youth are especially at risk. In one striking example, a comparison of whites and Chicanos in central California, the authors found that the long-run probability of abstinence among Chicanos 16 years old or younger was only 19%. In contrast, white youth just a little older, who began using drugs between the ages of 17 and 24, had a much better, 41% probability of remaining drug-free.
Data
The data analyzed by this study was collected during a seminal, multi-million dollar longitudinal survey of 846 narcotics addicts that was conducted by the UCLA Drug Abuse Research Center. Using official records and interviews with all the subjects, those conducting the survey were able to compile the entire addiction history of each of the respondents.
The ethnic make-up was 554 whites and 292 Chicanos, with 265 females and 581 males. The majority began using narcotics between ages 17 and 25. More than half did not finish high school.
The data was collected between 1978 and 1982. The data, say the authors, is arguably the best of its kind available in the world. Trends identified in the data remain current today, say the researchers. They recommend future studies of this type be conducted in other parts of the U.S. and the world to examine other populations, incorporate other policy variables (such as the reduction of drug-related crime), and to validate the research design.
| Group Description | Long-run Abstinence Probability |
|---|---|
| Age First Daily Use 16 or younger | |
| White-Central California1 | 27.8% |
| White-Southern California2 | 10.3% |
| Chicano-Central CA | 19.1% |
| Chicano-Southern CA | 6.6% |
| Age First Daily Use 17-24 | |
| White-Central CA | 41.6% |
| White-Southern CA | 17.6% |
| Chicano-Central CA | 30.5% |
| Chicano-Southern CA | 11.6% |
| Age First Daily Use 25 or above | |
| White-Central CA | 44.9% |
| White-Southern CA | 19.6% |
| Chicano-Central CA | 33.4% |
| Chicano-Southern CA | 13% |
2 Southern California: Orange County, Riverside, San Bernadino, and San Diego
The Institute for Operations Research and the Management Sciences (INFORMS®) is an international scientific society with 12,000 members, including Nobel Prize laureates, dedicated to applying scientific methods to help improve decision-making, management, and operations. Members of INFORMS work primarily in business, government, and academia. They are represented in fields as diverse as airlines, health care, law enforcement, the military, the stock market, and telecommunications.
Journal
Management Science