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Methadone maintenance to abstinence. How many make it?
1Psychology Service, Veterans Administration Medical Center, Birmingham, Alabama 35233.
The Journal of Nervous and Mental Disease
|July 1, 1988
Summary
Methadone maintenance detoxification completion rates significantly improved over time, rising from 39.7% to 76.3%. New medications accelerating the process were key, though they did not impact long-term abstinence.
Area of Science:
- Addiction Medicine
- Pharmacology
- Clinical Research
Background:
- Methadone maintenance is a cornerstone of opioid addiction treatment.
- Detoxification protocols have evolved since 1970.
- Assessing treatment efficacy requires standardized review criteria.
Purpose of the Study:
- To analyze trends in methadone maintenance detoxification outcomes.
- To compare completion rates based on treatment variables across different eras.
- To evaluate the impact of new pharmacological agents and psychotherapy.
Main Methods:
- A systematic review of methadone maintenance detoxification research since 1970.
- Analysis of data across three 5-year periods.
- Comparison of detoxification completion rates, considering program approval and psychotherapy.
Main Results:
- Overall detoxification completion rates increased progressively: 39.7% (1970-1975), 54.9% (1976-1980), and 76.3% (1981-1985).
- Program-recommended detoxification and psychotherapy-assisted detoxification showed higher completion rates.
- New pharmacological agents significantly shortened the detoxification interval and reduced withdrawal symptoms.
Conclusions:
- Advances in pharmacological agents are the primary driver of improved methadone detoxification completion rates.
- While new drugs ease withdrawal, they do not appear to influence long-term abstinence rates.
- Future research should focus on optimizing treatment protocols and long-term outcomes.