Question 14: Are there patient characteristics associated with the success of methadone maintenance treatment?
Answer: Yes. Patient characteristics associated with treatment success include the following:
- Age
- Age of first heroin use
- Overall drug-use history
- Severity and duration of drug use
- Emotional health
- Psychiatric health
- Social health
- Vocational stability
- Criminal history
Research Highlights
One review found the following characteristics to be associated with improved methadone outcomes: older age, absence of criminal behavior, shorter duration of opioid use, less severe psychopathology, being employed, being married, less polysubstance use, and higher expressed desire in getting help with a drug problem (Ward, Mattick, Hall, et al., 1998).
- In a review of 113 studies that attempted to evaluate the relationship of patient characteristics to retention and other outcomes (reported from 1971 to 1983), it was noted that patient characteristics probably accounted for only 25 to 45 percent of the variance in retention (McLellan, 1983).
- For methadone maintenance treatment patients in the Drug Abuse Reporting Program (DARP) studies, the most important predictors of posttreatment outcomes were (1) preadmission criminality and (2) measurements of crime, drug use, and employment during treatment. Of all the patient characteristics, chronic criminality is the strongest predictor of unfavorable posttreatment outcomes (Simpson and Sells, 1982).
- Ball and Ross’s work (1991) supports the finding that a younger age at the onset of heroin use is associated with poorer treatment outcomes. Overall, however, this study noted that patient characteristics had less impact on outcomes than program variables.
- Anglin and Hser (1990) note that better psychosocial adjustment predicts superior treatment outcomes. Psychosocial adjustment was described as an intact marriage, a job, a shorter history of drug abuse, lower levels of psychiatric dysfunction, and minimal or no criminal history.
- Rounsaville, Glazer, Wilber, et al. (1983) assessed 123 opioid addicts who were followed for 6 months after admission and found that outcome was predicted by the behavior examined: greater pretreatment criminality predicts criminal activity following discharge. Conversely, pretreatment employment predicts posttreatment employment. This study found that patients who abuse alcohol, are unemployed, are dually diagnosed, manifest psychopathology, and engage in criminality have poor outcomes.
Figure 29 illustrates that, overall, patients who demonstrate emotional, psychological, and social well-being generally experience greater treatment success than patients who have emotional, psychological, and social problems. Several studies have noted that certain patient characteristics, which are listed in Figure 29, are associated with success in methadone maintenance treatment (Anglin and Hser, 1990).
References
Anglin MD, Hser IY. Treatment of drug abuse. In: Tonry M, Wilson JQ (eds.). Drugs and Crime. Chicago: University of Chicago, 1990.
Ball JC, Ross A. The Effectiveness of Methadone Maintenance Treatment: Patients, Programs, Services, and Outcomes. New York: Springer-Verlag, 1991.
McLellan AT. Patient characteristics associated with outcome. In: Cooper JR, Altman F, Brown BS, Czechowicz D (eds.). Research in the Treatment of Narcotic Addiction. NIDA Treatment Research Monograph Series. Rockville, MD: National Institute on Drug Abuse, 1983.
Rounsaville BJ, Glazer W, Wilber CH, Weissman MM, Kleber HD. Short-term interpersonal psychotherapy in methadone maintained opiate addicts. Archives of General Psychiatry 1983;40:629-36.
Simpson DD, Sells SB. Effectiveness of treatment for drug abuse: an overview of the DARP research program.Advances in Alcohol and Substance Abuse 1982;2(1):7-29.
Ward J, Mattick RP, Hall W. Duration of methadone maintenance treatment. In: Ward J, Mattick RP, Hall W (eds.).Methadone Maintenance Treatment and Other Opioid Replacement Therapies. Amsterdam: Harwood Academic Publishers, 1998, p. 571
In This Section
- Certificate Programs
- Methadone Research Web Guide
- Acknowledgments
- Introduction
- Part A
- Part B
- Question 1: Is methadone maintenance treatment effective for opioid addiction?
- Question 2: Does methadone maintenance treatment reduce illicit opioid use?
- Question 3: Does methadone maintenance treatment reduce HIV risk behaviors and the incidence of HIV infection among opioid-depen
- Question 4: Does methadone maintenance treatment reduce criminal activity?
- Question 5: Does methadone maintenance treatment improve the likelihood of obtaining and retaining employment?
- Question 6: What effect can methadone maintenance treatment have on the use of alcohol and other drugs?
- Question 7: What components of methadone maintenance treatment account for reductions in AIDS risk behaviors?
- Question 8: Do risk factors for HIV infection acquisition and transmission differ for women compared with men in methadone maint
- Question 9: Is methadone maintenance treatment effective for women?
- Question 10: Is methadone safe for pregnant women and their infants?
- Question 11: Is it necessary to reduce methadone dose or detoxify women from methadone during pregnancy to protect the f
- Question 12: Is the long-term use of methadone medically safe, and is it well tolerated by patients?
- Question 13: Are there program characteristics associated with the success of methadone maintenance treatment?
- Question 14: Are there patient characteristics associated with the success of methadone maintenance treatment?
- Question 15: Are there cost benefits to methadone maintenance treatment?
- Question 16: What are the retention rates for methadone maintenance treatment?
- Question 17: Is mandated methadone maintenance treatment as effective as voluntary treatment?
- Question 18: What is the role of L-alpha-acetyl-methadol (LAAM)?
- Question 19: How do buprenorphine and methadone compare?
- Question 20: Can methadone and buprenorphine be abused?
- Part C
- Part D
- Methadone Research Web Guide Tutorial
- Questions: Methadone Research Web Guide
- Answers: Methadone Research Web Guide
- Methadone Research Web Guide
- Degree Programs
- Virtual Lectures
- Research Publications
Important Dates
NIDA International Forum
June 14–17, 2013
Online Registration Deadline:
May 6, 2013
FELLOWSHIPS
IAS/NIDA Fellowships
Application Deadline:
February 10, 2013
NIDA International Program Fellowships
Application Deadline:
April 1, 2013
Global Health Program for Fellows and Scholars
Application Deadlines: Vary
GRANTS
Brain Disorders in the Developing World: Research Across the Lifespan
(Non-AIDS)
R01 PAR-11-030and R21 PAR-11-031
Application deadline:
February 14, 2013
MEETINGS
American Association for the Advancement of Science
February 14–18, 2013
Boston, Massachusetts, USA
International Drug Abuse Research Society (IDARS)
April 15–19, 2013
Mexico City, Mexico
2013 International Conference on Global Health: Prevention and Treatment of Substance Abuse and HIV
April 17–19, 2013
Taipei, Taiwan
Yih-Ing Hser, Ph.D.