Predictors of attrition from a national sample of methadone maintenance patients.
BACKGROUND
Methadone substitution therapy is an effective harm reduction treatment method for opioid dependent persons. Ability to retain patients in methadone treatment is an accepted predictor of treatment outcomes.


OBJECTIVE
The current study evaluates the roles of psychiatric comorbidity, medical comorbidity, and sociodemographic characteristics as predictors of retention in methadone treatment utilizing retrospective analysis of data from a nationwide sample of patients in methadone treatment in the VA.


METHODS
Data were gathered using the VA's national health services use database. A cohort of veterans with a new episode of "opiate substitution" in fiscal year 1999 was identified, and their continuous service use was tracked through fiscal year 2002. The sample included a total of 2,363 patients in 23 VA medical centers. Survival analysis was used to explore factors associated with retention in methadone treatment.


RESULTS
Younger age, having a serious mental illness, being African American, or having race recorded as unknown were associated with lower rates of retention in methadone treatment programs in this population of veterans (controlling for site).


CONCLUSIONS
Given that extended methadone treatment is associated with improved outcomes while patients remain in treatment, more longitudinal studies using primary data collection are needed to fully explore factors related to retention. For the VA population specifically, further research is necessary to fully understand the relationship between race/ethnicity and treatment retention.


CONCLUSIONS
This is the first retention study the authors are aware of that utilizes data from a nationwide, multisite, population of participants in methadone treatment.
Mancino
Michael
M
Central Arkansas Veterans Healthcare System, North Little Rock, Arkansas, USA. mjmancino@uams.edu
Curran
Geoffrey
G
Han
Xiaotong
X
Allee
Elise
E
Humphreys
Keith
K
Booth
Brenda M
BM
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000367:Age Factors; D016208:Databases, Factual; D017831:Diagnosis, Dual (Psychiatry); D005260:Female; D006787:Hospitals, Veterans / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D044469:Racial Groups / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States; D014728:Veterans / Q000706:statistics & numerical data
D009294:Narcotics; D008691:Methadone
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