Factors associated with immediate dropout of outpatient treatment for drug abuse in Rio de Janeiro

The advantage of treatment of drug addiction over no intervention has long been recognized. The high dropout rates that are often reported in outpatient clinics may limit treatment effectiveness. This study aimed to analyze adherence to an outpatient program for drug addicts, mainly cocaine addicts, in Rio de Janeiro, Brazil, and its correlates. Of particular interest was immediate dropping out, defined as coming just once to the facility. The data were collected from medical charts and registers of a randomly selected sample of 480 patients. A total of 468 medical records were available for review, and 57% of the patients came just once to the facility. A negative association was found between immediately dropping out and female gender, being white, prescription of medication and use of multiple management resources by the therapist (referral to mutual support groups, social workers, family therapy and medical assessment, even with no prescription). A positive association was found with parental death in childhood, history of mental illness in the family and addiction to alcohol combined with abuse of other illicit substance(s). The high dropout rates associated with certain treatment approaches strongly indicate opportunities for improving care of drug addicts at that outpatient center.