title: One-year and cumulative retention as predictors of success in methadone maintenance treatment: a comparison of two clinics in the United States and Israel.
abstract: Outcome predictors between two methadone maintenance treatment clinics in Tel-Aviv, Israel, and Las Vegas, Nevada, were determined by comparing patients' characteristics. All patients admitted to the two clinics (302 from Las Vegas and 492 from Tel-Aviv) were studied with respect to variables at admission and follow-up. Las Vegas patients were older, contained more females, had more hepatitis C positive markers, and more urine analyses that were positive for cocaine, amphetamines, and tetrahydrocannabinol (THC) on admission than the Tel-Aviv patients. After 1 year, Tel-Aviv patients had higher retention (73.6% vs. 61.6%) and similar opiate abstinence (65.8% vs. 64.9%) compared to Las Vegas patients. Predictors for cumulative retention (Cox regression) for both clinics were higher methadone dosages greater than or equal to 100 mg/day (Tel-Aviv OR [odds ratio] = 2.1, 95% confidence interval [CI] = 1.6-2.9; Las Vegas OR = 1.8, 95% CI = 1.3-2.5). Also, in Tel-Aviv, predictors were no opiate use after 1 year (OR = 1.7, 95% CI = 1.4-2.2) and no benzodiazepine after 1 year, and in Las Vegas no cocaine and no amphetamines after 1 year and age less than or equal to 30 years. The two major predictors in the two clinics were successful in both outcomes: 1 year retention and opiate abstinence.
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for DrugAbuse, Treatment &Research, Tel-Aviv Sourasky Medical Center, Israel. einatp@tasmc.health.gov.il
authors.forename: Einat
authors.initials: E
authors.lastname: Peles
authors.forename: Shirley
authors.initials: S
authors.lastname: Linzy
authors.forename: Mary
authors.initials: M
authors.lastname: Kreek
authors.forename: Miriam
authors.initials: M
authors.lastname: Adelson
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006556:Heroin Dependence / Q000534:rehabilitation* / Q000652:urine; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D009505:Nevada / Q000453:epidemiology; D017678:Sex Distribution; D016320:Substance Abuse Treatment Centers; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000652:urine; D016019:Survival Analysis; D016896:Treatment Outcome; D014481:United States; D016903:Drug Monitoring
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone