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Published on: January 22, 2016
Rapid admission and retention on methadone
J F Maddux1, D P Desmond, M Esquivel
1Department of Psychiatry, University of Texas Health Science Center at San Antonio 78284-7792, USA.
The American Journal of Drug and Alcohol Abuse
|November 1, 1995
Summary
Rapid admission to methadone maintenance significantly reduces pretreatment attrition compared to slow admission. Prompt medication access improves opioid treatment entry without negatively impacting long-term retention or outcomes.
Area of Science:
- Addiction Medicine
- Clinical Psychology
- Public Health
Background:
- Opioid use disorder (OUD) treatment often faces challenges with patient attrition.
- Methadone maintenance therapy (MMT) is a cornerstone treatment for OUD.
- Pretreatment attrition, the dropout before receiving medication, is a significant barrier to MMT access.
Purpose of the Study:
- To compare the impact of rapid (1-day) versus slow (14-day) admission protocols on MMT.
- To assess effects on pretreatment attrition, treatment retention, and patient outcomes.
Main Methods:
- An open clinical trial with 186 eligible illicit opioid users.
- Random assignment to either rapid or slow MMT admission groups (93 subjects each).
- 1-year follow-up assessing attrition, retention, illicit drug use, and social performance.
Main Results:
- Pretreatment attrition was significantly lower in the rapid admission group (4%) compared to the slow admission group (26%).
- The risk of dropout before medication was 6 times higher in the slow admission group.
- 1-year continuous treatment retention rates were similar (43% rapid vs. 39% slow), though not statistically significant.
- No significant differences in illicit drug use or social performance between groups for those retained.
Conclusions:
- Rapid admission to MMT markedly reduces pretreatment attrition.
- Prompt access to methadone medication does not adversely affect long-term treatment retention or patient outcomes.
- Optimizing admission protocols can improve MMT accessibility and engagement for individuals with opioid use disorder.
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