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Randomized Trial of Standard Methadone Treatment Compared to Initiating Methadone without Counseling: 12-month Findings.

Author(s): Schwartz RP, Kelly SM, O'Grady KE, Gandhi D, Jaffe JH

Affiliation(s): Friends Research Institute, Inc. 1040 Park Avenue, Suite 103 Baltimore, MD 21201, rschwartz@friendsresearch.org Friends Research Institute, Inc. 1040 Park Avenue, Suite 103 Baltimore, MD 21201, skelly@friendsresearch.org University of Maryland, 1147 Biology/Psychology Bldg. College Park, MD 20742, keogradyfri@gmail.com University of Maryland School of Medicine, 110 S. Paca Street, Baltimore, MD 21201, dgandhi@psych.umaryland.edu Friends Research Institute, 1040 Park Avenue, Suite 103 Baltimore, MD 21201 University of Maryland School of Medicine, 110. S. Paca Street, Baltimore, MD 21201, jhjaffe@aol.com.

Publication date & source: 2011-10-26, Addiction., [Epub ahead of print]

Aims: This study aimed to determine the relative effectiveness of 12-months of Interim Methadone (IM; supervised methadone with emergency counseling only for the first 4 months of treatment), Standard Methadone treatment (SM; with routine counseling) and Restored Methadone treatment (RM: routine counseling with smaller caseloads). Design: A randomized controlled trial was conducted comparing: IM, SM, and RM treatment. IM lasted for 4 months after which participants were transferred to SM. Setting: The study was conducted in two methadone treatment programs in Baltimore, MD, USA. Participants: The study included 230 adult methadone patients newly-admitted through waiting lists. Measurements: We administered the Addiction Severity Index and a supplemental questionnaire at baseline, 4-, and 12-months post- baseline. Measurements included retention in treatment, self-reported days of heroin and cocaine use, criminal behavior and arrests, and urine tests for heroin and cocaine metabolites. Findings: At 12 months, on an intent-to-treat basis, there were no significant differences in retention in treatment among the IM, SM and RM groups (60.6%, 54.8% and 37.8%, respectively). Positive urine tests for the three groups declined significantly from baseline (ps < 0.001 and 0.003, for heroin and cocaine metabolistes respectively) but there were no significant Group x Time interactions for these measures. Thirty-one percent of the sample reported at least one arrest during the year, but there were no significant between-group effects. Conclusions: Limited availability of drug counseling services should not be a barrier to providing supervised methadone to adults dependent on heroin - at least for the first 4 months of treatment. (c) 2011 The Authors, Addiction (c) 2011 Society for the Study of Addiction.

Page last updated: 2011-12-09

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