Diminished illicit drug use as a consequence of long-term methadone maintenance

In the twenty-five years since its introduction as a treatment for opiate addiction, methadone maintenance has generated considerable controversy regarding both its appropriateness as a treatment modality and its efficacy in diminishing opiate abuse. Given current concerns regarding the spread of HIV amongst IV drug abusers, the role of methadone maintenance may be more important than ever. The present study was designed to examine continued illicit substance abuse by 229 patients enrolled in methadone treatment as a function of time in treatment (three months to over 10 years). Patients' urinalysis results collected over a 3 month period indicated that (a) cocaine use is a problem amongst methadone maintained individuals and does not appear to be related to length of time on the program, (b) cocaine use did not lead to escalated opiate and other illicit drug abuse, and (c) opiate abuse decreased significantly with time in treatment. Specifically, while 35% of the patients enrolled for less than 12 months were opiate free for the 3 month period, that value increased to 71% for patients enrolled for more than 4 years, and 85% for patients remaining in treatment for over 10 years. These results based on urinalysis support the conclusion of Ball and Ross (1991), based on ASI scores and criminality data, that methadone is an effective treatment modality for opiate addicted individuals.