Loitering by patients on methadone maintenance: a perception or a problem

Loitering has become an increasing matter of concern to both communities and staff involved in drug treatment programs. In order to determine the prevalence of this problem a retrospective two-year study was performed among clients enrolled in a community methadone maintenance treatment program (MM). Of 1064 persons enrolled in MM during this time, 190 (17.8%) were identified as loiterers with 121 (63.7%) loiterers actively enrolled in MM. No significant differences between loiterers and a matched group of MM clients were seen with respect to time in treatment, presence of drug abuse or excessive alcohol intake. Differences between loiterers and non-loiterers were observed with respect to criminal activity (29% vs. 11%, respectively, P less than 0.001), non-opioid drug abuse (78% vs. 67%, respectively, P less than 0.01) and productive activity (44% vs. 61%, respectively, P less than 0.01). Excessive alcohol intake was seen in 15.4% of the study group. No relationship existed between excessive consumption of alcohol and loitering, arrests, and use of mood altering drugs as determined by urinalysis. No relationship could be demonstrated between loitering and residence in the community surrounding the program. Only 11 (6%) of all loiterers lived within two blocks of the program boundaries, and only 59 (31%) resided within East Harlem. These findings suggest that loitering is a real cause for concern being engaged in mainly by individuals who are neither socially productive nor residents of the immediate community surrounding the program. It is therefore important to develop strategies for dealing with this problem not only to reassure the community but to facilitate rehabilitation.