Preliminary Findings: Preliminary Findings: Recovery Center Outcome Recovery Center Outcome StudyStudy

Robert Walker, Jennifer Cole, Erin Stevenson, Robert Walker, Jennifer Cole, Erin Stevenson, Allison Scrivner, TK Logan, Brittany Michael, Allison Scrivner, TK Logan, Brittany Michael, Jennifer Braun & Tom JacksonJennifer Braun & Tom Jackson

University of Kentucky Center on Drug and Alcohol University of Kentucky Center on Drug and Alcohol Research and UK Department of Behavioral Research and UK Department of Behavioral ScienceScience

Modeled after the Kentucky Treatment Modeled after the Kentucky Treatment Outcome Study (KTOS), RCOS examines Outcome Study (KTOS), RCOS examines baseline to follow-up changes in substance baseline to follow-up changes in substance abuse related behaviors among individuals abuse related behaviors among individuals participating in residential recovery participating in residential recovery services.services.

Beginning in 2009, Recovery Centers were Beginning in 2009, Recovery Centers were trained to collect data as individuals trained to collect data as individuals entered Phase I recovery services. entered Phase I recovery services.

BackgroundBackground

This is a pre-test/post-test design using two time This is a pre-test/post-test design using two time points for measuring behaviorpoints for measuring behavior

Baseline = admission to Phase I recovery servicesBaseline = admission to Phase I recovery services

Follow-up = 6 months after leaving Phase I Follow-up = 6 months after leaving Phase I (approximately 12 months post baseline)(approximately 12 months post baseline)

Individuals consent to be part of the follow-up Individuals consent to be part of the follow-up interviewsinterviews

The study is approved by the University of Kentucky The study is approved by the University of Kentucky Medical IRBMedical IRB

Study designStudy design

Two fundamental questions regarding outcomes from participation in the Recovery Centers are the focus of the report using RCOS data:

Do individuals participating in residential recovery experience significant improvement in the rate of abstinence after their residential stays?

Are there estimable cost reductions to society resulting from the Recovery Center episodes?

Research QuestionsResearch Questions

http://cdar.uky.edu/rcoshttp://cdar.uky.edu/rcos

This report summarizes the first wave of follow-up This report summarizes the first wave of follow-up interviews with 206 individuals who were in Phase I interviews with 206 individuals who were in Phase I recovery services in 2009 and 2010.recovery services in 2009 and 2010.

Individuals were randomly selected for follow-up Individuals were randomly selected for follow-up interviews.interviews.

To be eligible, individuals had to not be in controlled To be eligible, individuals had to not be in controlled environments at the time of follow-up.environments at the time of follow-up.

We had a 94.5% follow-up rate.We had a 94.5% follow-up rate.

Preliminary FindingsPreliminary Findings

The sample includes The sample includes 206 206 randomly selected cases who:randomly selected cases who:

Completed a baseline RCOS Completed a baseline RCOS interview at Phase 1 intakeinterview at Phase 1 intake

Completed follow-up Completed follow-up telephone RCOS interview telephone RCOS interview with UKCDAR about 6 months with UKCDAR about 6 months after leaving Phase 1after leaving Phase 1

Follow-up dates were Follow-up dates were between July 1, 2010 and between July 1, 2010 and June 30, 2011June 30, 2011

Follow-up interviews by Recovery CenterFollow-up interviews by Recovery Center

Recovery Centers Represented %George Privett Recovery Center 24.8Women’s Addiction Recovery Manor 19.9Brighton Center 16.0Morehead Inspiration Center 11.2Cumberland Hope Community Center for Women 9.7Liberty Place Recovery Center for Women 4.8The Healing Place Women’s Program 4.8The Hope Center for Women 4.4Trilogy Center 2.4Owensboro Regional Recovery Center 1.5The Healing Place Men’s Program 0.5

Sample Characteristics Percent or Mean

Female 61.7%Mean age 33.1 years   

Race   White 90.7% Black/African American 7.4% Multiracial 0.5% Other race/ethnicity (e.g., Native American, Hispanic, Asian) 1.5%   

Marital status   Never married 37.9% Married 16.5% Separated 11.7% Divorced/widowed 30.6% Cohabiting 3.4%   

Satisfaction with Recovery Center ServicesIndividuals reported high levels of satisfaction with the Recovery Center programs, rating their overall experience an average of 8.7 on a scale from 1 to 10 with 10 representing the best experience.

1 2 3 4 5 6 7 8 9 10 Worst Best

Use of Recovery Support GroupsThe number of individuals who reported going to mutual help recovery group meetings like AA/NA/MA increased from 45.3% at baseline to 81.1% at follow-up, representing a 79.1% increase.

Percent increase in use of mutual-help recovery meetings in the past 30 days

Four cases had missing data for mutual help recovery group meetings at follow-up. Significance established using z test for proportions.

+60.7%***+116.7%*** +79.1%***

Percent increase in recovery supportive interactions with family/friends in the past 30 days

One case reported transgender as gender and is excluded from this analysis. Significance established using z test for proportions.

+17.4%***+13.5%***+24.6%***

The average annual cost to society of an active alcohol or drug user in 2011 dollars is $25,189.

Applying this average annual cost to the 92.2% who were active users at baseline, we arrive at an annual cost to society of $4,785,910.

By follow-up after a Recovery Center stay of about 6 months, the cost of the 24.9% who were still active users and not yet abstinent can be estimated at $1,284,639.

Why abstinence is importantWhy abstinence is important

Substance Abstinence from Intake to Follow-up Substance Abstinence from Intake to Follow-up (n=206)(n=206)

Change in Cost to Society at Baseline and Follow-up (Amounts in millions of dollars) (n=206)

Examining the total avoided costs in relation to expenditures on recovery services, the figures translate to read that for every dollar spent on recovery,

there was a $2.92 return in avoided costs.

Cost Savings from Recovery Cost Savings from Recovery ServicesServices

The number of individuals who reported being arrested decreased significantly from 71.4% at baseline to 11.3% at follow-up, which was an 84.1% decrease.

The number of individuals who reported spending time in jail or prison decreased significantly from 74.1% at baseline to 11.3% at follow-up, which was an 84.9% decrease.

Decreased Criminal Justice Decreased Criminal Justice InvolvementInvolvement

Arrests by type

of crime

Estimated cost

per arrest

Past 12 month arrests

at baselin

e

Cost of crimes

at baseline

Past 12 month arrests

at follow-

up

Cost of crimes

at follow-

up

Reduction in cost

Drug $4,133 65$268,64

52 $8,266 $260,379

Property

$17,803 59$1,050,3

777

$124,621

$925,756

Violence

$41,274 15$619,11

01 $41,274 $577,836

DUI $27,171 27$733,61

70 0 $733,617

Total -- 166$2,671,7

4910

$174,161

$2,497,588

Reductions in victim costs of Reductions in victim costs of crimecrime

Jail time and costs 12 months prior to baseline

6 months prior to

follow-up

Reduction

Overall number of nights spent in jail or prison in the past 12 months*

15,923 882 15,041

Annualized total estimated cost of prison stays at an average of $46.65 per night

$742,808

$41,145 $701,663

Reductions in incarceration Reductions in incarceration costscosts

These preliminary findings suggest that both the behavioral outcomes and cost savings from recovery services are parallel to the outcomes from substance abuse treatment.

Recovery Centers add an important new component to the array of publicly supported substance abuse interventions.

State-funded treatment programs typically focus on shorter residential stays and a wide array of outpatient services.

Recovery Centers complement these services with longer term residential care and provide critical support to the aims of HB 463.

Implications for the futureImplications for the future

In the near future, this report will be posted at - In the near future, this report will be posted at -

http://cdar.uky.edu/rcos http://cdar.uky.edu/rcos

It will also be available at the Recovery Kentucky It will also be available at the Recovery Kentucky

website http://www.recoveryky.com/website http://www.recoveryky.com/

Questions or comments:Questions or comments:

Erin Stevenson or Robert WalkerErin Stevenson or Robert Walker

UK CDAR, 333 Waller Avenue, Suite 480UK CDAR, 333 Waller Avenue, Suite 480

Lexington, KY 40504Lexington, KY 40504

859-257-1521 859-257-1521

erin.stevenson@uky.edu or robert.walker@uky.edu erin.stevenson@uky.edu or robert.walker@uky.edu

To find the reportTo find the report