1. Residential Services for Drug Users What works? Dawn Griesbach Griesbach & Associates (formerly of the Effective Interventions Unit) 30 June 2005 Griesbach & Associates Social Research for Policy and Practice

2. 2 Outline of Talk What are residential services? What is the evidence of their effectiveness?

3. 3 What are residential services? Distinction between residential detoxification and residential rehabilitation. Not covering crisis services or supported accommodation.

4. 4 Residential detoxification In-patient (incl. Rapid Detox) Within a wider rehabilitation service Stand-alone service – often provided by voluntary or private sector

5. 5 Residential detoxification Aim is to get people off illicit drugs. … and do so humanely. Usually short-term – i.e., a few weeks. Only the first step.

6. 6 Residential rehabilitation Can be provided by statutory, voluntary or private sector. Aim is to keep people off drugs – i.e., drug-free lives. Usually long-term (several months). Residential rehab programmes are not all alike.

7. 7 Effectiveness of residential detoxification Very effective – more effective at getting people off drugs than community detox. BUT… –Only the first step

8. 8 Effectiveness of residential rehabilitation Is residential rehab effective? -- the wrong question. The right question: Who is residential rehab effective for -- and under what circumstances?

9. 9 For whom is residential rehabilitation most effective? Those who: Have engaged with services prior to entry Are drug-free prior to entry Are less severely dependent Have better social / family networks Have no history of psychiatric illness Have longer history of previous employment Have less risk-taking behaviour BUT…

10. 10 In what circumstances is residential rehabilitation most effective? Must be retained in treatment – programmes have very high drop-out rates Programme lasts at least three months (although 6 months – 1 year may be better for some people) Structured aftercare provided

11. 11 Further copies of the report http://www.scotland.gov.uk/library5/health/eiurdr.pdf

12. 12 Griesbach & Associates Social Research for Policy and Practice Contact details: No. 9, 190 Bruntsfield Place Edinburgh EH10 4DF Tel: 0131 228 1259 Mob: 07921 199 655 Email: d.griesbach@griesbach-research.co.uk Web: www.griesbach-research.co.uk