title: Effects of long-term, medically supervised, drug-free treatment and methadone maintenance treatment on drug users' emergency department use and hospitalization.
abstract: We examined the effect of drug treatment in 1996 on repeated (> or =2) emergency department visits and hospitalization in 1997 in a cohort of New York State Medicaid-enrolled human immunodeficiency virus (HIV)-positive and HIV-negative drug users. In HIV-positive drug users, the adjusted odds of repeated emergency department visits were increased for those receiving no long-term treatment (odds ratio [OR], 1.65; 95% confidence interval [CI], 1.04-2.75), whereas the adjusted odds for those receiving methadone treatment and those receiving drug-free treatment for > or =6 months did not differ. The adjusted odds of hospitalization in the HIV-positive group were higher for those receiving long-term methadone treatment (OR, 1.69; 95% CI, 1.14-2.55) and for those receiving no long-term treatment (OR, 1.91; 95% CI, 1.29-2.88), compared with those receiving drug-free treatment. In the HIV-negative group, these associations were similar but weaker. For both HIV-positive and HIV-negative drug users, long-term drug-free treatment was at least as effective as long-term methadone treatment in reducing use of services indicative of poorer access to care and/or poorer health.
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania 19104, USA. bturner@mail.med.upenn.edu
authors.forename: Barbara J
authors.initials: BJ
authors.lastname: Turner
authors.forename: Christine
authors.initials: C
authors.lastname: Laine
authors.forename: Chuya P
authors.initials: CP
authors.lastname: Yang
authors.forename: Walter W
authors.initials: WW
authors.lastname: Hauck
mesh_terms: D000328:Adult; D003695:Delivery of Health Care; D004630:Emergencies; D005260:Female; D015658:HIV Infections / Q000150:complications*; D018023:HIV Seronegativity; D006679:HIV Seropositivity; D006760:Hospitalization; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D019966:Substance-Related Disorders / Q000150:complications / Q000188:drug therapy*
chemical_list: D009294:Narcotics; D008691:Methadone