The Narconon Drug Rehabilitation Program: Ongoing Program Evaluation
| September 11-12, 1997 Presentation by Shelley L. Beckman. Ph.D. International Conference on Human Detoxification |
|||||||||||||||||||||
| Introduction During the past three years, there has been an ongoing evaluation of the Narconon program at two Narconon facilities in the United States. These facilities are located in Los Angeles, California, and Chilocco, Oklahoma. This ongoing evaluation is aimed at both monitoring some of the factors involved in delivery of the Narconon program and at assessing the long term results of this comprehensive socio-educational approach. The purpose of this evaluation was three-fold:
Study Design
|
|||||||||||||||||||||
| Education and Employment The educational level was comparable to some other drug rehabilitation programs. 20% of these clients had not completed high school. 80% had completed high school or above, 14% had gone to trade school or junior college after high school, 9% had completed college and 2% had post-graduate degrees such as a masters in business or science or a doctorate degree. Work Patterns About half of these clients were currently working. 60% report their usual pattern is to work full time, yet:
Many clients had recently lost their jobs – being fired or leaving work due to their drug abuse problems.
From a Longer Term View
There is a major problem with illegal activities in this group. As described later, the Narconon program does have a very positive effect on these statistics. |
|||||||||||||||||||||
| Drugs of Abuse The preferred drug of abuse does vary considerably among clients participating in the Narconon program. The primary drug of abuse for clients in this study was the following:
|
|||||||||||||||||||||
| During the time frame of this study, the most prevalent drug of abuse for the clients at the Los Angeles and Chilocco facilities was crack cocaine. Other prevalent drugs, in order, were alcohol, other forms of cocaine, heroin and other opiates, amphetamines, and some marijuana, LSD, PCP and inhalants. Mixtures of drugs were a problem for a large percentage of this study population. On average, these clients had used more than one drug in 8 days of the prior month. No primary drug of abuse could even be named by 13% of this study’s clients. About half of these were mainly cocaine and heroin addicts, with a wide variety of other combinations as well. Abuse at the two facilities – Chilocco and Los Angeles – varied and these facilities had different drugs of abuse then the facilities in Europe. For example the American Indian population at Chilocco was far more likely to abuse alcohol than other drugs and only the Chilocco facility dealt with inhalant addicts. Similarly, the primary drug of abuse in the Italian facilities was heroin rather than cocaine or crack during this time period. On average, these clients began using alcohol at age 15 and drugs at age 15 and a half . They had been using drugs, on average, for 15 years. Prior Attempts at Drug RehabilitationPrior drug or alcohol rehabilitation attempts were prevalent in this study population. 22% of the clients had previously done an alcohol rehabilitation program and 56% had previously attempted drug rehabilitation. For those who had tried rehab, the average was over three previous attempts. . 12% had been in some other form of rehab in the last 30 days. As a general statement, Narconon clients have had a long term addiction to drugs or alcohol and have encountered multiple prior failures in treatment. This is consistent with Narconon’s reputation for handling the hard core, so-called “intractable” drug addict. The long term efficacy study was designed to evaluate individuals who came for the first time to do the full Narconon program. Of the 273 clients monitored during this study, 184 qualified for this group. |
|||||||||||||||||||||
| Results Drug Tests During Program Delivery Urine samples were taken on intake, at two weeks, at one month and at two months into the program for a subset of the full study population. The clients were not warned that samples were to be taken.100% of the clients whose major drug was crack cocaine had positive urine tests. Other forms of cocaine showed 62% of clients with positive tests for drug metabolites. Almost 70% of amphetamine users had positive urine tests, 85% of opiate users and 50% of alcoholics. As clients progressed through the program, there was a steady decrease in both the percentage of clients testing positive for drugs of abuse and the level of drug found in urine. Testing in this case was occurring during the withdrawal and detoxification treatment periods. Minute but detectable levels of drug metabolites were found in a significant proportion of these clients for several weeks. On intake, 77% of clients tested positive for drug metabolites. By two weeks, 35% tested positive for drugs of abuse, though the majority of tests were in the low range. At one month 15% still tested positive for drug metabolites. The levels of drugs found at this time were quite low, not indicative of recent drug use. At two months, slightly higher levels of drug metabolites were found in four clients while two demonstrated low levels of metabolites. Two of those with the higher levels were clients who staff had suspected of drinking alcohol and they did test positive. For most follow-up samples, the level of drug metabolites was less than 1/20th of that found at intake. Although this does not preclude continuing drug use, the low levels suggest that what we are seeing is ongoing elimination of drug metabolites in most of these clients, particularly given the fact that they were on the detoxification program at the time. This portion of the overall study demonstrates that several weeks may be required for elimination of drug metabolites in some clients. Detectable levels of drugs continue to be eliminated for some weeks in at least a third of the Narconon clients tested. Monitoring Program Delivery Daily and weekly reports were made throughout the study period. These assisted Narconon management to isolate specific problem areas in delivery and correct or improve the quality of the program. Among the improvements implemented during this study were:
Weekly then monthly calls from staff helped clients through minor difficulties before they turned into major ones. |
|||||||||||||||||||||
| Measures of Efficacy Program Retention An important factor in judging the success of any program is whether or not it can keep its clients. Retention can refer to both the number of days at a facility and the amount of work completed. The most important point as regards retention is whether the client completed the program. Of the 273 clients who participated in this study, 66% completed the Narconon program. Similarly, of the 184 clients doing the full program for the first time, 67% completed their Narconon programs. Within this population, program completion did vary by drug of abuse. Of the 184 doing the full program for the first time, crack cocaine users had the poorest rate of program completion (60%) while users of other forms of cocaine had the highest completion rate. Reduction in Criminal Behavior (initial findings) There are 123 graduates of the full program in this study population. So far, 48 of these have been interviewed two years after program completion. For the 48 graduates who have been interviewed, results indicate a marked improvement in criminal behavior.
Conclusion |
|||||||||||||||||||||