(PS5-B40) Demographic and Clinical Predictors of Return to Use During Community Re-entry Following Residential Substance Use Treatment

Over four million adults in the United States receive treatment for substance use disorder (SUD) annually (SAMSHA, 2018). Community re-entry following residential SUD treatment is a critically vulnerable time, characterized by high rates of return to use (Brecht & Herbeck, 2014). Given the brief window of opportunity for prevention intervention, research is needed to identify factors that may help better detect individuals at risk for return to use during community re-entry. To this end, the purpose of the current study was to explicate demographic and clinical factors associated with higher return to use during community re-entry. Participants were 127 inpatients at a residential SUD treatment facility (M age = 40.15; 57.3% women; 77.8% white). Prior to discharge from residential SUD treatment, participants completed self-report measures assessing demographic (i.e., age, gender, race, education, income) and clinical (i.e., posttraumatic stress disorder [PTSD] symptoms, depression symptoms, substance use severity) factors. Approximately one month after discharge from residential SUD treatment, participants completed measures assessing alcohol and drug use during the period of community re-entry. Two-thirds of the sample reported return to use during the first 30 days of community re-entry: 50% returned to only alcohol use, 39.1% returned to only drug use, and 67.2% returned to alcohol and/or drug use. Independent sample t-tests revealed that individuals who returned to use had higher PTSD (M = 48.4, SD = 18.1),) and depression (M = 12.7, SD = 6.9) symptoms during residential SUD treatment compared to those who did not return to use alcohol (M = 41.4 [SD = 18.3] and M = 9.4 [SD = 5.9], respectively). Further, individuals who returned to use reported higher drug use severity (M = 6.6, SD = 3.6) and more alcohol-related harm (M = 26.8, SD = 18.1) compared to those who did not return to use alcohol (M = 4.8 [SD = 4.2] and M = 24.4 [SD = 17.8], respectively). In addition, individuals who returned to use were younger (M = 44.2, SD = 10.8) then those who did not return to use alcohol (M = 41.5 [SD = 10.4]) Finally, chi-squared tests of independence revealed that white people (vs. those from other racial and ethnic backgrounds) and males (vs. females) were more likely to return to use, with 62% of white individuals (compared to 38% of people of color) and 71% of males (compared to 29% females) returning to use. Results from this study inform the literature on demographic and clinical factors related to return to use during community re-entry. Our results highlight factors that may improve detection of individuals at risk for return to use during community re-entry. Knowledge of these factors can aid prevention efforts and intervention development during the critical window immediately following substance use treatment.