Identifying Methadone Maintenance Clients at Risk for Poor Treatment Response

Pretreatment and Early Progress Indicators

Published in: Drug and Alcohol Dependence, v. 55, no. 1-2, 1999, p. 25-33

Posted on RAND.org on January 01, 1999

by Andrew R. Morral, Mark A. Belding, Martin Y. Iguchi

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Exhaustive searches have uncovered few demographic or other pretreatment factors that reliably predict performance in substance abuse treatment. In this study, the authors evaluate whether early treatment response offers improved prediction of treatment response 6 and 9 months later. New admissions to methadone maintenance treatment (n=59) were dichotomized into outcome groups based on treatment retention and ongoing drug use as revealed by urinary results 6 and 9 months after admission. Regression analyses revealed that two early (week 2) performance measures — counseling attendance and opiate abstinence — could be used to correctly classify the outcomes of more than 80% of the sample. Strikingly, of the 20 participants who neither submitted an opiate-negative urine sample in week 2 nor attended at least two scheduled counseling sessions by that time, not one achieved a superior 6-month outcome. The odds of having a superior outcome increased considerably for those who submitted two opiate negative urine samples and attended two counseling sessions in week 2. Thus, 6-month outcomes were well predicted by treatment performance in week 2. Similar results are reported for month 9 outcomes.

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