title: When is less treatment better? The role of social anxiety in matching methadone patients to psychosocial treatments.
abstract: In response to a need to match drug users to the most appropriate and cost-effective level of care, it was hypothesized the socially anxious methadone-maintained patients would attain greater benefit from coping skills training provided in the context of a low-intensity enhanced standard methadone maintenance intervention (E-STD) than in the context of a high-intensity, socially demanding day treatment program (DTP). Social anxiety was assessed in 307 methadone-maintained patients using the Social Anxiety and Distress Scale prior to randomization to either E-STD or DTP. The hypothesis was supported: Socially anxious patients were drug free longer during treatment, were more likely to be abstinent at treatment completion, and had greater reductions in HIV risk behaviors if assigned to the lower intensity intervention, which was provided at 1/3 the cost of the DTP.
authors.affiliation: Substance Abuse Center, Yale University School of Medicine, New Haven, Connecticut 06529, USA. kelly.avants@yale.edu
authors.forename: S K
authors.initials: SK
authors.lastname: Avants
authors.forename: A
authors.initials: A
authors.lastname: Margolin
authors.forename: T R
authors.initials: TR
authors.lastname: Kosten
authors.forename: B J
authors.initials: BJ
authors.lastname: Rounsaville
authors.forename: R S
authors.initials: RS
authors.lastname: Schottenfeld
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D001008:Anxiety Disorders / Q000150:complications* / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000150:complications* / Q000534:rehabilitation*; D018579:Patient Selection; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D011615:Psychotherapy, Group / Q000379:methods*; D012309:Risk-Taking; D012917:Social Adjustment; D016896:Treatment Outcome
chemical_list: D008691:Methadone