title: Outcome of a second episode of methadone maintenance.
abstract: This paper reports the treatment progress of methadone maintenance clients who were discharged or withdrew from treatment and then were readmitted for a second episode of treatment. Thirty-nine clients in a contingency contract condition remained in treatment long enough (6 months) during both the initial and a second treatment episode, to be exposed to discharge sanctions that were part of the contingency contract. Of these clients 34 failed treatment during the initial treatment episode. Nine (26%) of these initial treatment failures improved their performance in the second episode compared to the first, and only one (20%) of five initial treatment successes who left treatment during their first treatment episode for non-contract reasons showed a poorer performance (failing the second after succeeding in the first episode). Of 17 clients in a condition that applied no contingencies for positive urines, three of 14 (21%) who failed during the initial treatment episode improved their performance, and two of three (67%) who succeeded during the initial treatment episode failed in the second episode. For a subset of clients the efficacy of contingency contracting may not be realized until it is reapplied during a subsequent admission.
authors.affiliation: Veterans Affairs Medical Center, Seattle, WA, USA.
authors.forename: D A
authors.initials: DA
authors.lastname: Calsyn
authors.forename: E A
authors.initials: EA
authors.lastname: Wells
authors.forename: A J
authors.initials: AJ
authors.lastname: Saxon
authors.forename: T R
authors.initials: TR
authors.lastname: Jackson
authors.forename: V V
authors.initials: VV
authors.lastname: Stanton
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use* / Q000652:urine; D011897:Random Allocation; D019966:Substance-Related Disorders / Q000534:rehabilitation*; D016896:Treatment Outcome
chemical_list: D008691:Methadone