Long-term follow-up of clients of high- and low-dose methadone programs

A six- to seven-year follow-up of 1971-1973 admissions to three methadone hydrochloride maintenance programs was conducted. Ninety percent of those alive were interviewed. Two of the programs used a high-dose, long-retention policy, while the third used low doses and a relatively strict policy with respect to involuntary termination for program violations. Retention was much longer for the two high-dose programs, and during the six to seven-year periods from program entry to interview, the clients had significantly less arrest, incarceration, narcotic addiction, and self-reported criminal behavior than did the patients in the low-dose program. These advantages persisted until the time of interview and existed for periods with as well as without methadone. In addition, the overall social costs in the high-dose programs were substantially less than in the low-dose program.