Thesis defense Ruud Rutten (Donders Series 619)

3 October 2023

Promotor: Prof. dr. A.F.A. Schellekens
Co-promotor: Em. Prof. dr. G.M. Schippers (Universiteit Amsterdam)

Profiling substance use disorders patients and their level of care in addiction treatment

The aim of this thesis is to explore data driven, clinical heterogeneity in addiction care in a large set of naturalistic patient and treatment data. Specifically we aimed at answering the following questions:

1. Can clinical heterogeneity be clarified by looking at the symptoms of SUD in their interrelationship?
2. Can we define stages in the course of a SUD?
3. Can the amount and focus of treatment episodes be related to patient characteristics?

Taken together, the performed studies showed that SUD patients in a in large, regional addiction treatment organization showed a differentiated severity profile (in stages, symptom networks and severity scores). They also differed in utilization of care in addiction treatment, in both focus and amount. The more severe patients’ problems are, the more treatment they consume. Limitations in general functioning was more predictive for care utilization than severity of SUD symptoms. So overall, we found that patients and practitioners seem to make rational use of the broad-spectrum treatment facilities available in the Netherlands.

Based on the found results, recommendations have been formulated in the practical, policy-related field, as well as for scientific research.