Providing medical care to methadone clinic patients: referral vs on-site care.
OBJECTIVE
Intravenous drug users are at high risk for medical illness, yet many are medically underserved. Most methadone treatment programs have insufficient resources to provide medical care. The purpose of this study was to test the efficacy of providing medical care at a methadone clinic site vs referral to another site.


METHODS
Patients with any of four target medical conditions were randomized into an on-site group offered medical care at the methadone treatment clinic and a referred group offered medical care at a nearby clinic. Entry to treatment and use of medical services were analyzed.


RESULTS
Of 161 intravenous drug users evaluated, 75 (47%) had one or more of the target medical conditions. Fifty-one were randomized. In the on-site group (n = 25), 92% received medical treatment; in the referred group (n = 26), only 35% received treatment.


CONCLUSIONS
Providing medical care at a methadone treatment program site is more effective than the usual referral procedure and is a valuable public health intervention.
Umbricht-Schneiter
A
A
Behavioral Pharmacology Research Unit, Johns Hopkins Medical School, Baltimore, Md.
Ginn
D H
DH
Pabst
K M
KM
Bigelow
G E
GE
D005260:Female; D015658:HIV Infections / Q000628:therapy; D006296:Health Services; D006801:Humans; D006973:Hypertension / Q000628:therapy; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D012017:Referral and Consultation; D012749:Sexually Transmitted Diseases / Q000628:therapy; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000150:complications / Q000534:rehabilitation; D014374:Tuberculin Test; D014376:Tuberculosis / Q000175:diagnosis
D008691:Methadone