Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #118149

Lev S. Sverdlov, MD, PhD, DMS, Health Outcomes and Statistics, Health Dialog, 39 Forest Ave., Portland, ME 04101, 207-822-3773, lsverdlov@healthdialog.com, Leigh Ainslie Henderson, PhD, DASIS, Synctics for Mnagement Decisions, 1901 North Moore Street, Arlington, VA 21205, and Thomas M. Brady, PhD, Office of Applied Studies, Substance Abuse and Mental Health Services Administration, 1 Choke Cherry Road, Rockville, MD 20857.

Between 1992 and 2001 heroin admissions increased by 64 percent (TEDS 2001). The most frequently used agent in medically supervised treatment of heroine addiction is methadone. Retention (defined as length of stay in treatment - LOS) is one of the important measures of the effectiveness of methadone treatment. Objective: To explore the association between retention in methadone treatment, the level of a daily dose of methadone, severity of heroin use disorder, and duration of heroin use. Data samples: 30,411 discharges reported to TEDS by 22 States in 2001, and 428 discharges representing 109,973 methadone discharges nationally as reported to the Alcohol and Drug Services Study (ADSS). Methods: polynomial regression, Cox's proportional hazards regression, principal component analysis (PCA). Results: The study has introduced the Proxy Composite Severity Index (PCSI). The 2-dimensional distributions of LOS by severity, by duration, and by the prescribed methadone dose were bimodal. The 3–dimensional distribution of LOS by duration and the prescribed methadone dose had two distinctive “hills.” It suggested the existence of hidden factors, which were explored using PCA. The results of analyses of data from different datasets using different methodological approaches correspond with and complement each other. The report will illustrate the complexity of the association of retention with severity of addiction, duration of heroin use, and prescribed methadone dose. It will emphasize an importance of studying tolerance toward methadone. The processes forming the population of heroin addicts admitted to/discharged from methadone treatment will be discussed.

Learning Objectives:

• Learn about the Proxy Composite Severity Index
• Recognize processes forming the population of methadone treatment admissions/discharges
• Learn about the association between retention, sevetrity of heroin abuse, and tolerance toward methadone

Keywords: Substance Abuse Treatment, Outcomes Research

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.