title: Cocaine abuse sharply reduced in an effective methadone maintenance program.
abstract: A comprehensive study of an urban methadone clinic with supervised urine analyses for illicit drugs was conducted over an 18 month period for a 133 patient cohort as they entered or remained in methadone maintenance for narcotic addiction. Overall retention during the study was 85%, with significantly (p < .05) higher daily methadone doses (mean 67.1 mg +/- 2.1) in those patients still in treatment at the end of the study. Predictably, illicit opioid use was dramatically reduced, to 10% as measured by urine toxicology in the last month of treatment. Moreover, significantly more patients stopped regular cocaine abuse (69%) than started using cocaine (10%, Fisher's exact test, p = .02). Thus, with effective methadone maintenance using adequate dosages, the majority of patients remain in treatment and reduce cocaine abuse as well as illicit opioid use, with implications for public health by reducing the spread of infectious diseases including hepatitis B, C, D and human immunodeficiency virus (HIV-1).
authors.affiliation: Rockefeller University, The Laboratory of the Biology of Addictive Diseases, New York, NY 10021, USA. borgl@rockvax.rockefeller.edu
authors.forename: L
authors.initials: L
authors.lastname: Borg
authors.forename: D M
authors.initials: DM
authors.lastname: Broe
authors.forename: A
authors.initials: A
authors.lastname: Ho
authors.forename: M J
authors.initials: MJ
authors.lastname: Kreek
mesh_terms: D000328:Adult; D000368:Aged; D002391:Catchment Area, Health; D019970:Cocaine-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation* / Q000652:urine; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D015995:Prevalence; D012189:Retrospective Studies; D015813:Substance Abuse Detection; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone