Predictors of retention in methadone programs: A signal detection analysis

• Published in: Drug and alcohol dependence Vol. 83; no. 3; pp. 218 - 224
• Main Authors: Villafranca, Steven W., McKellar, John D., Trafton, Jodie A., Humphreys, Keith
• Format: Journal Article
• Language: English
• Published: Shannon Elsevier Ireland Ltd 27.07.2006; Elsevier Science
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; California; Combined Modality Therapy - psychology; Combined Modality Therapy - statistics & numerical data; Comorbidity; Counseling; Dose-Response Relationship, Drug; Drug addiction; Drug replacement therapy; Female; Follow-Up Studies; Health Services Research - statistics & numerical data; Heroin Dependence - epidemiology; Heroin Dependence - psychology; Heroin Dependence - rehabilitation; HIV Infections - prevention & control; HIV Infections - psychology; Humans; Male; Medical sciences; Methadone; Methadone - therapeutic use; Methadyl Acetate - therapeutic use; Middle Aged; Narcotics - agonists; Narcotics - therapeutic use; Opioids; Patient Dropouts - psychology; Patient Dropouts - statistics & numerical data; Patient Satisfaction; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retention; Risk-Taking; Signal detection; Socioeconomic Factors; Street Drugs; Substance-Related Disorders - epidemiology; Substance-Related Disorders - psychology; Substance-Related Disorders - rehabilitation; Toxicology; Veterans; Veterans - psychology; Veterans - statistics & numerical data; California; Retention; Signal detection; Methadone; Human; Drug addiction; Program; Memory; Prediction; Opiates; Narcotic analgesic; Psychophysics; Addiction; Analysis; Predictive factor; Psychiatry
• ISSN: 0376-8716; 1879-0046
• DOI: 10.1016/j.drugalcdep.2005.11.020

Retention in Opioid Agonist Therapy (OAT) is associated with reductions in substance use, HIV risk behavior, and criminal activities in opioid dependent patients. To improve the effectiveness of treatment for opioid dependence, it is important to identify predisposing characteristics and provider-related variables that predict retention in OAT. Participants include 258 veterans enrolled in 8 outpatient methadone/ l-alpha-acetylmethadol (LAAM) treatment programs. Signal detection analysis was utilized to identify variables predictive of 1-year retention and to identify the optimal cut-offs for significant predictors. Provider-related variables play a vital role in predicting retention in OAT programs, as higher methadone dose (≥59 mg/day) and greater treatment satisfaction were among the strongest predictors of retention at 1-year follow-up.