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Medical maintenance: an interim report

E C Senay1, A Barthwell, R Marks

  • 1Department of Psychiatry, University of Chicago, USA.

Journal of Addictive Diseases
|January 1, 1994
PubMed
Summary
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Methadone maintenance treatment can be safely reduced with monthly urine screens and fewer visits. This approach maintains patient stability and frees resources for more addiction treatment, potentially slowing HIV transmission.

Area of Science:

  • Addiction Medicine
  • Public Health

Background:

  • Methadone maintenance treatment (MMT) is a cornerstone for opioid use disorder.
  • Optimizing MMT service delivery is crucial for resource allocation and patient outcomes.

Purpose of the Study:

  • To evaluate a reduced-service model for methadone maintenance treatment.
  • To assess patient adherence, satisfaction, and long-term outcomes.

Main Methods:

  • A pilot study randomly assigned 130 MMT patients to an experimental group (reduced services) or a control group (standard services).
  • The experimental group received monthly non-random urine screens, quarterly random screens, monthly counseling/doctor visits, and bi-monthly methadone pickup.
  • A subsequent Study of Medical Maintenance (SMM) extended the experimental model to two years for new and pilot study participants.

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Main Results:

  • 73% of subjects in the pilot study completed one year in good standing, with no significant differences between groups.
  • Subject satisfaction was high, with the Institutional Review Board deeming a return to standard services a hardship.
  • In the SMM protocol, 66% of new subjects (71/107) are in good standing, and pilot subjects maintain good performance for over four years.

Conclusions:

  • A reduced-service model for methadone maintenance is effective and well-tolerated.
  • This model conserves resources that can be redirected to increase access to addiction treatment.
  • Optimized MMT delivery may contribute to reducing HIV transmission among injection drug users.