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A randomized controlled trial of interim methadone maintenance.
Robert P Schwartz1, David A Highfield, Jerome H Jaffe
1Friends Research Institute, Inc, Baltimore, MD 21201, USA. rschwartz@friendssocialresearch.org
Archives of General Psychiatry
|January 4, 2006
Summary
Interim methadone maintenance significantly increases entry into comprehensive treatment for opioid dependence. This approach effectively reduces heroin use and criminal behavior while individuals await full treatment.
Area of Science:
- Addiction Medicine
- Public Health
- Clinical Trials
Background:
- Long waiting lists for methadone maintenance treatment (MMT) are a barrier to care.
- Effective alternatives are needed to mitigate risks associated with continued heroin dependence.
Purpose of the Study:
- To compare interim methadone maintenance with standard waiting list control.
- To assess the impact on MMT entry, substance use, and criminal behavior.
Main Methods:
- Randomized controlled trial with 319 participants.
- Interim MMT provided daily methadone and emergency counseling for up to 120 days.
- Control group received standard referral to community-based programs.
Main Results:
- 75.9% of interim MMT participants entered comprehensive treatment versus 20.8% of controls.
- Interim MMT group showed significant reductions in heroin use and positive drug tests.
- Reduced drug spending and illegal income were reported in the interim group.
Conclusions:
- Interim methadone maintenance substantially improves access to comprehensive MMT.
- This strategy is effective in reducing heroin use and criminal activity for those awaiting treatment.