A Systematic Review and Meta-Analysis of the Efficacy of the Long-Term Treatment and Support of Substance Use Disorders. 

The reconceptualization of substance use disorders (SUD) as a chronic phenomenon calls for a paradigm shift in service provision, particularly by way of long-term treatment and support. Studies that have evaluated the efficacy of long-term treatment models seem to indicate that they are an improvement on more standard short-term treatments, even though these studies do not take the durations into consideration. Objective Measure the efficacy of SUD treatments and support lasting 18 months or more regarding their ability to decrease substance use as compared to shorter treatments.

A meta-analysis based on a systematic literature review was conducted. Eight databases were consulted for peer-reviewed studies. Certain variables were coded as moderators: intervention length, participant characteristics, and treatment characteristics.

The main results suggest that the people who received a planned long-term treatment or support had a 23.9% greater chance of abstaining or consuming moderately than did people who received a shorter standard treatment (OR=1.347 [IC 95%= 1.087 -1.668], p < .006, adjusted OR = 1.460 [CI 95% = 1.145 -1.861]). None of the moderation analyses revealed any variation in the efficacy of the long-term treatments and support.

The results led us to clearly opt in favor of the necessity of providing long-term services for people with persistent SUD. The reconceptualization of the SUD as a chronic disorder among people with this problem leads us to reconsider both the length of the services provided and the paradigms underlying their organization. Services should be adjusted according to changes in intensity, length of treatment and support should be personalized, and services should be organized in response to the complexity of each person’s needs.