Influence of retroactive disability payments on recipients' compliance with substance abuse treatment

OBJECTIVE: This study examined whether substance abusers who received large retroactive payments from Social Security disability programs were more likely to terminate residential treatment precipitously than those who did not receive payments. METHODS: The records of 43 patients of a long-term residential treatment facility who received disability payments at some point during their treatment stay were blindly examined. Twenty-six of these patients received a large one-time retroactive payment representing money that accumulated during processing of the claims. To test the hypothesis that receipt of such a payment would lead to precipitous discharge, a survival regression model was used. A control group of nonrecipient patients was sampled at a comparable point in treatment. RESULTS: Subjects in the recipient group were significantly more likely to have unplanned discharges than those in the comparison group. CONCLUSIONS: These preliminary data suggest that large cash infusions can be disruptive to the course of treatment for substance abusers.