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The 130th Annual Meeting of APHA |
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The 130th Annual Meeting of APHA |
Harold A. Pollack, PhD, Health Management and Policy, University of Michigan School of Public Health, 109 Observatory, SPH II, Ann Arbor, MI 48109-2029, 734-936-1298, haroldp@umich.edu and Thomas D'Aunno, PhD, School of Social Service Administration, University of Chicago, 969 E. 60th Street, Chicago, IL 66037.
Context. Several studies conducted in the early 1990s showed that the majority of the nation’s methadone maintenance programs did not use treatment practices that met established standards for the care of heroin users. Effective treatment is critical given the upsurge in heroin use and the continued role of injection drug use in the HIV and hepatitis C epidemics.
Objectives. To examine the extent to which the nation’s methadone maintenance programs have changed to provide adequate methadone doses; to identify factors associated with variation in program performance
Design. Survey of program directors and clinical supervisors.
Setting. The sample includes programs that vary by ownership (for-profit, public, private non-profit) and setting (e.g., free-standing, hospital-based)
Participants. Data were collected from a nationally representative panel of methadone treatment programs in 1988, 1990, 1995 and 2000
Main outcome measures. Percent of program patients receiving methadone doses of less than 40, 60, and 80 mg/d; percent of treatment programs with maximum dose levels below 60 mg/d or 80 mg/d
Results. The percent of patients receiving methadone doses below the recommended 60 mg/d has decreased from 79.5% in 1988 to 35.1% in 2000. Similarly, the percent of programs that limit dose levels to 60 mg/d or less dropped from 27% to 7.9%. Programs with greater percentages of African-American patients were especially likely to dispense low doses, while programs with JCAHO accreditation were more likely to provide adequate doses.
Conclusions. Efforts to improve methadone treatment practices appear to be making progress, but many patients are still receiving substandard care.
Learning Objectives:
Keywords: Injection Drug Users, Methadone Maintenance
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.