title: The effectiveness of outreach case management in re-enrolling discharged methadone patients.
abstract: BACKGROUND
  Heroin dependence is a chronic relapsing disease often requiring multiple treatment experiences. Despite this knowledge, few methadone programs follow-up with discharged patients who frequently continue to engage in risky behaviors. The aim of this project was to evaluate the effectiveness of outreach case management for post-discharged methadone patients.
  
  
  METHODS
  At 90 days post-discharge 128 active out of treatment heroin users were randomly assigned to receive either a passive referral (PR) for drug treatment (n=52) or were provided with 6 weeks of outreach case management (OCM), an intervention designed to help motivate and coach patients to re-enter treatment (n=76).
  
  
  RESULTS
  At 6 months post-baseline 29% of the OCM participants had successfully re-enrolled in drug treatment compared to 8% of the PR participants (chi(2)=7.6, d.f.=1, p=0.006). A logistic regression analysis showed that OCM participants were nearly six times more likely than PR participants to re-engage in MMT (OR=5.8, CI=1.6-20.8, p=0.008). Moreover, OCM subjects had fewer opiate and cocaine positive urines at the 6-month follow-up compared to PR subjects.
  
  
  CONCLUSIONS
  The findings highlight the importance of engaging former patients in treatment and actively assisting in treatment re-entry. OCM is a simple approach to reduce the number of out-of-treatment drug users, although availability of treatment funding limits enrollment opportunities.
authors: University of Pennsylvania School of Medicine, 3900 Chestnut St., Philadelphia, PA 19104, USA. coviello_d@mail.trc.upenn.edu
authors: Donna M
authors: DM
authors: Coviello
authors: Dave A
authors: DA
authors: Zanis
authors: Susan A
authors: SA
authors: Wesnoski
authors: Arthur I
authors: AI
authors: Alterman