Contingent methadone delivery: effects on illicit-opiate use.

Area of Science:

• Addiction Medicine
• Pharmacology
• Clinical Psychology

Background:

• Opioid dependence treatment often involves methadone maintenance.
• Outpatient detoxification programs face challenges with patient relapse.
• Methadone's reinforcing properties may be leveraged in treatment.

Purpose of the Study:

• To investigate the efficacy of contingent methadone dose supplements in reducing illicit opiate use.
• To compare contingent, non-contingent, and control group outcomes during methadone detoxification.
• To assess the impact of supplementary methadone on treatment retention and attendance.

Main Methods:

• 39 patients in methadone outpatient detoxification were randomized into three groups: contingent, non-contingent, and control.
• All groups received gradual methadone dose reduction.
• Contingent and non-contingent groups could receive up to 20 mg daily methadone supplements, contingent on opiate-negative urinalysis.

Main Results:

• The contingent group showed significantly lower opiate-positive urines (14%) during weeks 8-11 compared to non-contingent (38%) and control (50%) groups.
• Availability of methadone supplements improved treatment retention.
• Clinic attendance was higher in groups receiving dose supplements compared to the control group.

Conclusions:

• Contingent methadone dose supplements are effective in reducing illicit opiate relapse during outpatient detoxification.
• Leveraging methadone's reinforcing properties can enhance treatment adherence and retention.
• This strategy shows promise for improving outcomes in opioid dependence treatment.