Staff attitudes and retention of patients in methadone maintenance programs

A study was made of the effect of staff commitment to abstinence-oriented policies on retention of patients in methadone maintenance. Staff working in six public methadone programs in Sydney, Australia, were surveyed in 1989 and 1992 using the Abstinence Orientation Scale. The association of the clinics' median Abstinence Orientation scores with the time in treatment of a random sample of their 1988-1989 admissions was summarised using Cox regression. Patients' risk of discharge increased by a factor of three with every one unit increase in the clinics' median Abstinence Orientation scores, (RR 3.4, 95% CI 2.3-5.0). Abstinence-oriented policies were shown to disadvantage ex-prisoners.