The original Matrix protocol for outpatient stimulant abuse treatment was
developed in the early eighties in response to an overwhelming demand for
cocaine abuse treatment. The development of the written protocol was funded by
a Small Business Innovative Research grant being offered through the National
Institute on Drug Abuse (Rawson, Obert, et al., 1989). The developers of the
Matrix Model were committed to using empirically-based findings as the basis
for choosing which interventions would be incorporated into the treatment
model. In addition treatment approaches were evaluated with regard to practical
utility as opposed to theoretical or ideological considerations.
The need for relevant, empirically-based treatments targeting methamphetamine
users has prompted the increasing use of the Matrix Institute.(It is the only
specific treatment noted by the National Institute on Drug Abuse as a
scientifically based approach in “Principles of Drug Addiction Treatment, a
Research-based Guide,” 1999.)The current program consists of
-
relapse prevention groups
-
education groups
-
social support groups
-
individual counseling (three 1 hour individuals in 52 weeks)
-
urine and breath testing
delivered in a structured manner over a 52-week period. The treatment is a
directive, non-confrontational approach focusing on current issues and behavior
change.
Group meetings are guided by written topics and focus on current issues and
activities. Over a period of years the model has been broadened to treat
alcohol and opioid dependencies, and now generalizes well to treatment of all
drugs of abuse.The program is administered in the format noted in the table,
below.
| OUTPATIENT PROGRAM SCHEDULE
|
| Week
|
Monday
|
Tuesday
|
Wednesday
|
Thursday
|
Friday
|
Saturday & Sunday
|
Weeks
1 Thru 4
(6.5 hours per week)
|
6-7 pm
Early
Recovery
Skills
7-8:30 pm
Relapse
Prevention
|
|
|
|
|
|
|
|
|
7-8:30 pm
Family
Education
Group
|
|
|
|
|
|
|
|
|
6-7 pm
Early
Recovery
Skills
7-8:30 pm
Relapse
Prevention
|
12-Step
Meetings
and Other
Recovery
Activities
|
Weeks
5 Thru 16
(4 hours per week)
|
7-8:30 pm
Relapse
Prevention
Group
|
|
|
|
12-Step
Meeting
|
|
|
|
7-8:30 pm
Family
Education Group
Or
Transition;
Group
|
|
|
|
12-Step
Meeting
|
|
|
|
7-8:30 pm
Relapse Prevention
Group
|
Weeks
17 Thru 52
(1.5 hours per week)
|
|
|
|
|
|
|
7-8:30 pm
Social
Support
|
|
|
|
|
|
|
| Urine testing and breath-alcohol testing
conducted weekly One individual session is included in each of the program
phases.
|
Several evaluations of the Model have supported its usefulness and efficacy with
stimulant abusers. Methamphetamine users appear to respond to treatment
similarly to cocaine users and many continue to show improvements at follow-up.
Following is a short list of research findings:
-
(Rawson et al., 1986) This pilot study reported significantly less cocaine use
by the Matrix patients at 8 months after treatment admission as compared to
control groups. This study also found that clients were significantly more
likely to return to cocaine use if they continued to drink alcohol (of those
who drank alcohol, 50% relapsed to cocaine use; of those who did not drink,
only 6% relapsed), prompting the program developers to insist on complete
abstinence from all drugs.
-
An open trial was conducted with 486 cocaine users who received treatment in
California between 1986 and 1990 (Rawson et al., 1991) which further supported
the results from the pilot study that the Matrix Model was a viable treatment
approach that could retain patients for substantial treatment episodes.
There was a tentative connection between the duration of treatment and drug use
status through six months of treatment.
-
A review of 500 charts of methamphetamine- and 224 cocaine-abusing patients who
were treated in California between 1988 and 1995 compared responses to Matrix
Model treatment (Huber et al., 1997). The Matrix Model was equally well
received by cocaine and methamphetamine users and both groups had a very a
favorable response to treatment.
-
A followup sample of 114 patients out of the 500 referred to in the Huber et
al. (1997) report was followed at 2-5 years after treatment. There was a
significant change in self-reported methamphetamine use in the 30 days prior to
treatment (86% reporting use), and 30 days prior to follow-up (17.5% reporting
use). Of the 54 who had reported daily use at baseline, 39 (72.2%) were
abstinent at follow-up. At treatment admission 26% of the follow-up sample were
employed compared to 62% employed at follow-up. Many users maintained sobriety
for periods of more than two years.
The Matrix Model was evaluated in a randomized, controlled study funded by the
Center for Substance Abuse Treatment with over 1,000 methamphetamine users in a
national multi-site trial (Rawson et al., 2000). In this project the
Matrix Model was adapted for use specifically with a methamphetamine-using
patient population. The treatment response by patients to the Matrix Model was
found to be superior to the “treatments as usual.” The Model has been
effectively used in clinical practice with a variety of patients of every
ethnicity, race, sexual orientation and gender.