Staffing Patterns in Methadone Treatment: An Examination of Differences Across Treatment Programs

Although staffing patterns in a treatment facility can have a large impact on treatment provision, costs, and the overall quality of care, relatively little is known about staffing within substance abuse treatment programs and whether staffing patterns differ by program characteristics. The objective of our study is to examine staffing patterns across selected treatment services and administrative activities for methadone treatment programs. We conduct descriptive analyses to estimate the average full-time equivalents (FTEs) by staff type (e.g., physician, counselor, RN) employed by methadone programs and to identify which staff types perform selected treatment services and activities. We examine whether any differences in staffing patterns exist among key program characteristics—ownership, clinic size, organizational structure, and urbanicity. We also examine the division of time spent between administrative duties versus direct care services by staff type across treatment programs. Finally, we examine whether changes in staffing patterns are observed in programs 6 months after the pursuit of accreditation. Our data are from a nationally-representative sample of 170 methadone treatment programs that participated in the Center for Substance Abuse Treatment's Evaluation of the Methadone/LAAM Treatment Program Accreditation Project. Data on staffing were collected using the Substance Abuse Services Cost Analysis Program (SASCAP), which collected detailed information on the allocation of staff hours across 8 primary methadone treatment services and 4 administrative activities. Supported by NIDA grant # R01 DA15655.