Useful Predictors of Outcome in Methadone-Treated Patients

This study examined the ability of patient and treatment factors to predict outcome in methadone treatment. Participants were opioid-dependent outpatients drawn from a clinical trial comparing the efficacy of three fixed-doses of methadone (50, 20, 0 mg). Multiple regression analyses determined the relative contributions of patient and treatment characteristics to the prediction of three outcomes-retention, opioid use, and cocaine use. For longer retention in treatment, a significant percent of the variance was contributed by older age, being black, more counseling, fewer lifetime months of opioid use, and higher methadone dose. Higher rates of opioid-positive urines during the treatment were predicted by higher early-treatment rates of opioid-positive urines, more lifetime months of cocaine use, fewer days of cocaine use in the month prior to admission, and lower doses of methadone. Higher rates of cocaine-positive urines during treatment were predicted by higher early-treatment rates of cocaine-positive urines, lower doses of methadone, and lower scores on the Addiction Severity Index psychiatric severity score at admission. This study provides further data demonstrating higher doses of methadone improve treatment retention and decrease illicit opioid and cocaine use, and suggest that early intensive monitoring of patients via urine testing can be extremely valuable in identifying patients at risk for continued opioid and cocaine use.