Addiction Therapeutic communities: residents’ retention, early dropout, and their correlates over fourteen years

Background: Long-term retention is a reliably well-studied factor associated with enhanced outcomes in addiction therapeutic communities (ATCs). Staying no less than three months is considered to be a critical time for program effectiveness. I plan to estimate retention rates of Saudi AATCs for three months, completion of therapy (stay at least six months), and early abandonment and investigate its correlations in this study. Methods A cohort retrospective study where data of all residents admitted to all Saudi ATCs since their establishment in 2000 through September 2014 were collected from their AATCs files. At the time of the study, there were five AATCs, two of them in Dammam, one in Riyadh, one in Jeddah, and the fifth one was in Taif. Date of admission, date of discharge, socio-demographic variable, and type of drug used of all of the five ACS were reported. Retention rate at 3 and 6 months and dropout in the first week were calculated. Results out of the 2050 files, 2003 of data was suitable for analysis. All of the residents were male adults. More than two-thirds of patients were younger than 40 years of age and most of them were singles (64%), unemployed (68%), and had intermediate or secondary school education (73%). Forty-six percent of patients reported Opioids use, 36% hash, 34% amphetamine, and 19% reported alcohol abuse. The retention rate for three months and six months was 45% and 28% respectively, and 8.3% dropped outs in the first week. The median duration of stay was 77 days. Residences in TC 1, TC 2, and TC 4 were less likely to stay for more than three months. Unemployment, and being students was associated with completion of treatment (stay > 6 months), while admission to TC 1 and TC-2 was associated with drop out prior completing the treatment program. Conclusion Three-month retention rates of 45% in Saudi addiction ATCs is reasonable and consistent with reported rates worldwide. In addition, treatment completion rate and drop out within the first week are at least comparable to the average rates recorded elsewhere. These rates can be considered as indicators for successful Saudi ATCs programs. However, there have been substantial variation between the different Saudi AATCs which may require further exploration to determine the factors related to these disparities.