Patient Characteristics Associated with Retention in a Methadone Maintenance Program

The purpose of this study was to determine if it is possible to differentiate between types of patients as to their ability to stay in a methadone maintenance program. Since medical and counseling staff cannot work with ail patients simultaneously, such information would be helpful in identifying who needs the most help. This study is based on most admissions (679 cases) to the Dole-Nyswander methadone maintenance program from its initiation in 1964 to 15 March 1968. Each patient was followed-up to determine whether they were still in the program 2 years later. This meant the last admissions were followed to 15 March 1970. Eighty percent of both males and females were continuously in the program for 2 years or longer. (1) As expected, those patients who did poorer were those who, had longer conviction records, were multiple drug users, abused alcohol, were not employed at admission, were older and were not married. (2)Other factors that were expected to be related to program stay, but proved to have little or no relationship were; age when started using heroin, number previous hospitalization, length of education and longest job held. (3)Patients with relatively short usage or very long usage did better than those in the middle range (8 to 19 years of use). (4)When clinical experience was used as a guide for combining single factors some interesting classifications of patients emerged. For example, the best group were those who were abusers for 5 years or less and had no multiple drug or alcohol abuse. This group had a 96 percent outcome rate. The poorest group were those who had 12 to 15 years of abuse and 7 or more convictions. This latter group had 58 percent in program 2 years after admission. (5)When the single factors were combined by using configural analysis, a somewhat different patient classification was developed. The patient types had outcome rates which ranged from 56 to 94 percent.