Retention, HIV risk, and illicit drug use during treatment: methadone dose and visit frequency.
OBJECTIVE
This study examined two major methadone treatment factors, visit frequency and methadone dose, posited to be important in reducing intravenous drug use and human immunodeficiency virus (HIV) transmission.


METHODS
One hundred fifty opiate-dependent subjects randomly assigned to four groups received 50 or 80 mg of methadone and attended a clinic 2 or 5 days per week.


RESULTS
Survival analysis indicated higher dropout rates for groups having five vs two visits per week (Chi2[1]=7.76). Higher proportions of opiate-positive results on urine screens were associated with lower methadone doses (F[1,91]=4.74).


CONCLUSIONS
Receiving take-home doses early in treatment enhanced treatment retention. The 50-mg dose combined with five visits per week produced the worst outcome. Fewer visits enhanced retention at 50 mg, but opiate use rates were higher at this dose than they were for either 80-mg group. The HIV infection rate at entry was 9%. No subjects seroconverted during the study. Risk behaviors for acquired immunodeficiency syndrome declined over time regardless of group/dose assignment. These results have important implications for modification of regulatory and clinic policy changes.
Rhoades
H M
HM
Substance Abuse-Medications Development Research Center, Department of Psychiatry and Behavioral Sciences, School of Medicine, University of Texas-Houston, 77030, USA.
Creson
D
D
Elk
R
R
Schmitz
J
J
Grabowski
J
J
D000328:Adult; D001521:Behavior Therapy; D005260:Female; D015658:HIV Infections; D006801:Humans; D013287:Illicit Drugs; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000628:therapy*; D010352:Patient Dropouts / Q000706:statistics & numerical data; D012307:Risk Factors; D012309:Risk-Taking; D015813:Substance Abuse Detection; D016019:Survival Analysis
D013287:Illicit Drugs; D008691:Methadone