Thomas M. Brady, PhD¹, Sameena Salvucci, PhD², Lev S. Sverdlov, MD, PhD², Alisa Male, MA², Hannah Kyeyune, MS², and Emmanuel Sikali, MS². (1) Office of Applied Studies, Substance Abuse and Mental Health Services Administration, Parklawn Building, 5600 Fishers Lane, Suite 16-105, Rockville, MD 20857, (301) 443-9049, tbrady@samhsa.gov, (2) Synectics for Management Decisions, Inc., 1901 North Moore Street, Suite 900, Arlington, VA 22209

Research shows that longer retention in treatment is an important measure of treatment effectiveness. A NIH consensus panel recommended a daily methadone dose of 60 mg as a best practice in methadone maintenance. The focus of this research is to examine the association between retention and level of methadone dosage as recommended by the NIH panel. Method: A sample of 428 methadone clients in non-hospital residential and outpatient treatment facilities from the Alcohol Drug and Services Study (ADSS) was used. This sample represents 109,973 methadone clients nationally in treatment. Methadone dose was defined as the daily dosage received by clients two weeks after their first treatment. Findings: Only 32 percent of clients nationally received at least the recommended 60mg of methadone/day. Cox’s regression using SUDAAN indicated that the relative risk of a client leaving treatment was lower among those who received a daily methadone dose of 60mg/day or more compared to those who received less than 60mg/day, while controlling for various sociodemographic and facility characteristics (hazard ratio 0.69; 95% CI 0.50-0.96). Discussion: The recommended daily methadone dose of 60mg/day is associated with longer retention in treatment. Since it is estimated that almost two thirds of methadone clients nationally do not get the recommended dosage, providing an adequate dose remains an important issue in effective methadone treatment. Effective methadone treatment for heroin use is critical given the 40 percent increase from 1992 to 2000 in U.S. treatment episodes associated with heroin dependence.

Learning Objectives:

• Identify the recommended daily dose level for successful outpatient methadone maintenance treatment based on recent national consensus panels;
• describe methadone clients most likely to receive the recommended dosage; and
• recognize at least two client-level risk factors for shorter stays in outpatient methadone maintenance treatment.

Keywords: Outcome Measures, Methadone Maintenance

Presenting author's disclosure statement:
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.