title: Gender-specific predictors of retention and opioid abstinence during methadone maintenance treatment.
abstract: OBJECTIVE
  Retention in methadone maintenance treatment (MMT) for 1 year is associated with positive outcomes including opioid abstinence, however, most studies have not investigated gender differences. We hypothesized that predictors of retention and opioid abstinence would differ between men and women, and aimed to determine which factors best predict retention and abstinence for each gender.
  
  
  METHODS
  Data were available for 290 patients (173 M, 117 F) admitted to outpatient MMT. Regression analyses, stratified by gender, were conducted to identify unique predictors of MMT retention (<1 vs. >1 year) and opioid abstinence rate (proportion of opioid-free urine samples up to 1 year retention).
  
  
  RESULTS
  Gender did not significantly predict treatment retention (mean = 231 days, 39% retained > 1 year) or opioid abstinence (49% overall). For males, significant predictors of > 1-year retention were urine samples negative for opioids (odds ratio [OR] = 6.67) and cannabinoids (OR = 5.00) during the first month, and not cocaine dependent (OR = 2.70). Significant predictors of higher long-term opioid abstinence were first-month urine samples negative for opioids and cocaine metabolites. For females, significant predictors of >1-year retention were first-month urine samples negative for cocaine metabolites (OR = 4.00) and cannabinoids (OR = 9.26), and no history of sexual victimization (OR = 3.03). The only significant predictor of higher opioid abstinence rate was first-month opioid-free urine samples.
  
  
  CONCLUSIONS
  These findings indicate gender-specific predictors of MMT retention and opioid abstinence. Future studies on MMT outcomes should examine each gender separately, and consider unique pathways by which females and males adhere to, and benefit from MMT.
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: levinea@uwindsor.ca.
authors: Amanda R
authors: AR
authors: Levine
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: llundahl@med.wayne.edu.
authors: Leslie H
authors: LH
authors: Lundahl
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: dledgerw@med.wayne.edu.
authors: David M
authors: DM
authors: Ledgerwood
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: mlisiesk@med.wayne.edu.
authors: Michael
authors: M
authors: Lisieski
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: grhodes@med.wayne.edu.
authors: Gary L
authors: GL
authors: Rhodes
authors: Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Detroit, MI 48201, USA. Electronic address: mgreen@med.wayne.edu.
authors: Mark K
authors: MK
authors: Greenwald
mesh_terms: D000328:Adult; D000368:Aged; D002186:Cannabinoids / Q000652:urine; D003042:Cocaine / Q000652:urine; D019970:Cocaine-Related Disorders / Q000453:epidemiology; D005260:Female; D005544:Forecasting; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation*; D012737:Sex Factors; D012959:Socioeconomic Factors; D015813:Substance Abuse Detection; D016896:Treatment Outcome
chemical_list: D002186:Cannabinoids; D009294:Narcotics; D003042:Cocaine; D008691:Methadone
keywords: Abstinence; Gender; Methadone maintenance; Predictors; Retention; Treatment