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Client retention in the British Columbia Methadone Program, 1996-1999
John F Anderson1, Leanne D Warren
1Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver, BC. John.Anderson@gems3.gov.bc.ca
Summary
Methadone treatment retention in British Columbia is favorable, with 52% of patients remaining in care after one year. Program expansion did not negatively impact retention, highlighting the importance of adequate daily methadone dosing for sustained treatment engagement.
Area of Science:
- Addiction Medicine
- Pharmacotherapy
- Public Health
Background:
- Limited research exists on Canadian methadone treatment effectiveness.
- This study examines one-year retention in the British Columbia Methadone Program during expansion (1996-1999).
- Identifies factors influencing patient retention in methadone maintenance treatment.
Purpose of the Study:
- To describe one-year retention rates for methadone program entrants in British Columbia.
- To investigate factors influencing retention, such as age and methadone dosage.
- To assess the impact of program expansion on treatment retention.
Main Methods:
- Utilized prescription data from the BC Triplicate Prescription Program for 1996-1999 entrants.
- Employed logistic regression to evaluate retention status and covariates at one year post-entry.
- Assessed effects of retention misclassification using a Cox model for continuous or short-carry dosing.
Main Results:
- Fifty-two percent of entrants retained methadone treatment at one year; 24% returned after a temporary departure.
- Age at entry and average daily methadone dose were significant predictors of retention.
- Program expansion did not significantly alter retention trajectories after accounting for client age and dose.
Conclusions:
- British Columbia Methadone Program retention rates are comparable to published data.
- Program expansion is not associated with reduced retention when controlling for key client factors.
- Sufficient daily methadone dosing is critical for initial retention and re-engagement in treatment.