Correlates of retention on the South Australian Methadone Program 1981-91

Abstract

Objectives: To investigate correlates of retention on the South Australian Methadone Program during 1981–91. Design: Retrospective study of a non‐stratified random sample of 229 HIV‐negative clients who received methadone between January 1981 and June 1991. Data were collected from clinical records of the 229 HIV‐negative clients and also from the 40 clients known to be infected with HIV during the decade. Results: Being HIV positive, receiving larger maximum doses of methadone, receiving methadone from a private pharmacy and enrolling later in the decade were all associated with longer retention times on the program. Conclusions: This study supports the findings of previous studies, that maximum dose of methadone is crucial to retention in methadone programs, But even allowing for maximum dose, obtaining methadone from a private pharmacy was also strongly associated with retention on the program. The more ‘humane’ clinic policy later in the decade is likely to have increased retention and reduced illicit drug use also.

Barriers to Opioid Substitution Treatment Access, Entry and Retention: A Survey of Opioid Users, Patients in Treatment, and Treating and Non-Treating Physicians

“…Conversely, a flexible clinic policy (i.e. an orientation to maintenance as opposed to lower doses and abstinence) [23,25] , optional counseling [21,25] , less expensive fees for treatment [21,25] and greater accessibility (such as dispensing hours) [26] generally maximize treatment retention rates. Clearly, despite a shift, among the scientific community at least, towards addiction being viewed as a chronic, relapsing illness, rather than a moral or self-control problem, ideology still wins over scientific evidence in some treatment settings.…”

An overview of systematic reviews of the effectiveness of opiate maintenance therapies: available evidence to inform clinical practice and research

“…All the studies included are randomized clinical trials (RCTs), but 10 studies included in the review on bMethadone Maintenance at Different Dosages for Opioid DependenceQ (Faggiano et al, 2003) are controlled perspective studies (CPS) (Caplehorn & Bell, 1991;Caplehorn, Dalton, Cluff, & Petrenas, 1994;Caplehorn, Irwig, & Saunders, 1996;D'Ippoliti, Davoli, Perucci, Pasqualini, & Bargagli, 1998;Del Rio, Mino, & Perneger, 1997;Gaughwin, Solomon, & Ali, 1998;Gossop, Marsden, Stewart, & Treacy, 2001;Maddux, Prihoda, & Vogtsberger, 1997;Torrens, Castillo, & Pérez-Solà, 1996;Van Ameijden, Langendam, & Coutinho, 1999). The analysis of CPS is presented separately from the others.…”

Predictors of Attrition from a National Sample of Methadone Maintenance Patients

“…Older patients have been shown in several studies to have higher retention rates than younger patients (11, 12, 18, 20–23), and there is some indication that African Americans have lower retention rates than non-African Americans (12, 24–27). At least two studies show retention is related to higher rates of medical comorbidity (28, 29). Previous research indicates that higher dose is the most consistent predictor of treatment retention (22, 26, 30–32).…”