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Table of Contents
Vol. 18, No. 1, 2012
Issue release date: December 2011
Eur Addict Res 2012;18:1–11

Effectiveness of Therapeutic Communities: A Systematic Review

Malivert M. · Fatséas M. · Denis C. · Langlois E. · Auriacombe M.
aAddiction Psychiatry, Laboratoire de psychiatrie et CNRS-USR-3413-Sanpsy, Université Bordeaux Segalen, bDépartement d’Addictologie, CH Charles Perrens et CHU de Bordeaux, and cCentre Émile Durkheim – Science politique et sociologie comparatives (UMR 5116), Université Bordeaux Segalen, Bordeaux, France

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Background: Therapeutic communities (TCs) are drug-free residential settings, focused on psychosocial rehabilitation. While TCs are considered an effective method, the bulk of the research evidence is from poorly controlled studies. The goal of this study was to evaluate TC effectiveness in terms of abstinence and to determine if there were predictive factors of abstinence. Methods: The search used Medline up to January 30, 2011 and was based on a systematic review method. Studies on retention in treatment and/or substance use were considered. Results: Of the 321 studies retrieved from Medline, 12 met selection criteria including overall 3,271 participants from 61 TCs. On average, subjects stayed in TC a third of the planned time. The completion rate ranged from 9 to 56%. All studies showed that substance use decreased during TC, but relapse was frequent after TC. Treatment completion was the most predictive factor of abstinence at follow-up. Surprisingly, psychiatric comorbidities did not appear associated with relapse or with dropout. Conclusions: There was a drop in consumption after TC, but long-lasting benefits were uncertain. Further studies are needed in order to compare the efficacy of TC programs and other types of treatment settings for substance-related disorders.

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Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in goverment regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
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