Participation in an outreach-based coupon distribution program for free methadone detoxification

Area of Science:

• Public Health
• Addiction Medicine
• Epidemiology

Background:

• Injection drug use remains a significant public health concern, often associated with high rates of HIV infection.
• Many individuals requiring drug detoxification services do not access treatment, necessitating innovative recruitment strategies.

Purpose of the Study:

• To identify characteristics of injection-drug users (IDUs) that predict coupon redemption for free methadone detoxification.
• To compare the effectiveness of 21-day versus 90-day methadone detoxification coupons in facilitating treatment participation.

Main Methods:

• A cohort of 4,390 current heroin users in New Jersey were recruited via street outreach.
• Participants received randomly assigned coupons for 21 or 90 days of methadone detoxification and underwent interviews and HIV testing.
• Multiple regression analysis identified variables associated with coupon redemption.

Main Results:

• Overall coupon redemption rate was 58.5%, with 90-day coupons redeemed more frequently (59.9%) than 21-day coupons (56.9%).
• Among redeemers, 43.6% were new to formal drug treatment, and 44.9% were HIV seropositive.
• Predictors of redemption included frequent heroin use, prior detoxification, frequent injection, bleach needle cleaning, non-Black race, Hispanic ethnicity, and residence in Newark.

Conclusions:

• Outreach-based coupon distribution is an effective method for recruiting large numbers of never-treated and HIV-infected IDUs into addiction treatment.
• The 90-day methadone detoxification program demonstrated higher effectiveness in facilitating treatment entry compared to the 21-day program.