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Risk factors associated with dropout and readmission among First Nations individuals admitted to an inpatient alcohol and drug detoxification program

Russell Callaghan is with the Department of Psychology, University of Toronto, Toronto, Ont.

Correspondence to: Russell C. Callaghan, Centre for Addiction and Mental Health, T401, 33 Russell St., Toronto ON M5S 2S1; fax 416 595-6899; Russell_Callaghan{at}camh.net

Background: There is a need for clinically relevant research into treatment for substance abuse among Aboriginal people. In this study, I aimed to provide a predictive model of dropout from and readmission to an inpatient detoxification program in a large treatment sample of Aboriginal patients.

Methods: I reviewed the medical charts of all self-reported First Nations people (n = 877) admitted to an inpatient detoxification centre in British Columbia, between Jan. 4, 1999, and Jan. 30, 2002, and used binary logistic regression models to identify predictors of dropout from and readmission to the program. Each of these models was validated using an independent subset of the treatment sample.

Results: Overall, 254 (29.0%) people dropped out of the program, and 219 were readmitted. Statistically significant predictors of treatment dropout were a preferred drug other than alcohol (odds ratio [OR] 1.67, 95% confidence interval [CI] 1.12–2.50) and self-referral (OR 1.89, 95% CI 1.28–2.80). Statistically significant predictors of readmission to inpatient detoxification within a 1-year period were a previous history of detoxification treatment (OR 3.52, 95% CI 2.16–5.75) and residential instability (OR 1.82, 95% CI 1.11–2.99).

Interpretation: Although factors were identified that are associated with each of treatment dropout or readmission for detoxification, only the latter can be reliably predicted by them.

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