‘Just Say No’: A preliminary evaluation of a three-stage model of integrated treatment for substance use problems in conditions of medium security

Preliminary outcome data evaluating a three-stage model of integrated treatment for substance use problems in conditions of medium security are presented to address the lack of previous research in this area. Stage 1 and Stage 2 are 12-week treatment groups, supporting participants in becoming and remaining substance free, respectively, through motivational interviewing, psycho-education, and relapse prevention approaches. ‘Just Say No’ (JSN) is a participant-led social group to support continued abstinence throughout admission and up to six months post-discharge. Case notes of all in-patients in 2005 were screened, revealing that 32 (74%) of in-patients had a prior history of substance use problems. Of the 19 who received treatment, 14 (74%) became abstinent by the end of 2005, rising to 15 (79%, missing = 3) by the end of June 2006. However five refused, of whom three (60%) became abstinent, and eight were not referred due to unstable mental state or imminent discharge. There was a significant effect of treatment on whether or not in-patients became drug-free, although only JSN attendance had a significant effect on whether they remained drug-free. By the end of treatment (and maintained at six-month follow-up), participants' self-reported insight and confidence to make changes to their substance use had increased, and there was a trend towards participants reporting more adaptive beliefs about substances and less craving for cannabis. Participants were also satisfied with the treatment intervention.