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Counselor effectiveness in a methadone maintenance program

B Longwell, J Miller, A W Nichols

The International Journal of the Addictions

|February 1, 1978

Summary

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Counselor type did not impact heroin use in methadone maintenance patients. However, patients without a counselor for at least one-third of the study period showed significantly higher rates of heroin use.

Area of Science:

Addiction Medicine
Clinical Psychology
Public Health

Background:

Methadone maintenance is a key treatment for opioid use disorder.
The role of counselor characteristics in treatment outcomes requires further investigation.

Purpose of the Study:

To evaluate counselor effectiveness in a methadone maintenance program.
To determine if ex-addict (EA) versus non-addict (NA) counselors influence heroin use.

Main Methods:

Assessed counselor effectiveness using patient urinalysis for heroin use.
Compared heroin use rates across different counselor assignment groups (EA, NA, mixed, single, none).
Included 253 patients in a methadone maintenance program.

Main Results:

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No significant differences in heroin use were observed between patients with EA counselors, NA counselors, or mixed assignments.
Patients with single EA or NA counselors showed no significant difference in heroin use compared to each other.
Patients lacking a counselor for one-third or more of the study period exhibited a significantly higher percentage of positive urine tests for heroin.

Conclusions:

Counselor background (ex-addict vs. non-addict) does not appear to significantly impact heroin use in this methadone maintenance population.
Consistent counseling is crucial, as a lack of consistent counselor support is linked to poorer treatment outcomes, indicated by increased heroin use.