Validation and development of a self-report outcome measure (MAP-sc) in opiate addiction

Criminally invalid: the treatment outcome profile form for substance misuse

Aims and Method

To audit completion of the Treatment Outcome Profile (TOP) form in individuals attending substance misuse services in England. Forms are completed at the start of treatment and every 3 months thereafter. All forms at 3-drug treatment services were inspected over 6 months.

Results

Forms were inspected for 200 service users; 86% were fully completed. Two-thirds (67%) of service users had no declared funding for illicit drug use in the previous month (mean spending £988; s.e. = 149) despite denying any paid employment and criminal activity.

Clinical Implications

The section on crime in the TOP form is unreliable and completely invalid.

Prevalence of childhood attention deficit hyperactivity disorder in opiate-dependent adults

Background. There is a clear association between childhood attention deficit hyperactivity disorder and substance use disorders in adulthood. Symptoms of attention deficit disorder may also persist into adulthood. The study aimed to determine the prevalence of childhood ADHD in a sample of treatment seeking opiate-dependent adults. Methods. Treatment-seeking opiate-dependent subjects completed the Utah adult ADHD screening test and the self-report early delinquency scale. Results. A total of 15% were "likely" and 49 were "highly likely" to have suffered ADHD in childhood. The averages scores for the delinquency scales were over 6 times those reported from population norms. Conclusion. Symptoms of childhood ADHD is common in adults with opiate dependence. The residual symptoms in adults should be investigated as may be amenable to newer treatments for adult attention deficit disorder.