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Methadone Patients in the Therapeutic Community: A Test of Equivalency.

Drug and Alcohol Dependence 2009;100(1-2):100-106. [doi: 10.1016/j.drugalcdep.2008.09.009]

James L. Sorensen, PhD (University of California, San Francisco, CA/AZ Node), Siara Andrews, PsyD (University of California, San Francisco, CA/AZ Node), Kevin L. Delucchi, PhD (University of California, San Francisco, CA/AZ Node), Brian Greenberg, PhD (Walden House, CA/AZ Node), Joseph R. Guydish, PhD (University of California, San Francisco, CA/AZ Node), Carmen L. Masson, PhD (University of California, San Francisco, CA/AZ Node), Michael Shopshire, PhD (University of California, San Francisco, CA/AZ Node).

Residential therapeutic communities (TCs) have demonstrated effectiveness, yet for the most part, they adhere to a drug-free ideology that is incompatible with the use of methadone. This CTN platform study used equivalency testing to explore the consequences of admitting opioid-dependent clients currently on methadone maintenance treatment (MMT) into a TC. The study compared 24-month outcomes between 125 MMT patients and 106 opioid-dependent drug-free clients with similar psychiatric history, criminal justice pressure and expected length of stay who were all enrolled in a TC. Statistical equivalence was expected between groups on retention in the TC and illicit opioid use. Secondary hypotheses posited statistical equivalence in the use of stimulants, benzodiazepines, and alcohol, as well as in HIV risk behaviors. Results found that the mean number of days in treatment was statistically equivalent for the two groups (166.5 for the MMT group and 180.2 for the comparison group). At each assessment, the proportion of the MMT group testing positive for illicit opioid use was also found for stimulant and alcohol use. The groups were statistically equivalent for benzodiazepine use at all assessments except at 24 months where 7% of the MMT group and none in the comparison group tested positive. Regarding injection- and sex-risk behaviors, the groups were equivalent at all observation points. In conclusion, the authors found that methadone patients fared as well as other opioid users in TC treatment. These findings provide additional evidence that TCs can be successfully modified to accommodate MMT patients. (Article (Peer-Reviewed), PDF, English, 2009)

Keywords: Alcohol | Benzodiazepines | CTN platform/ancillary study | Methadone maintenance | Opioid dependence | Sexual risk behavior | Stimulant abuse | Retention - Treatment | Statistical analysis | Therapeutic community | Drug and Alcohol Dependence (journal)

Document No: 330, PMID: 19013724, PMCID: PMC2606930

Submitted by the CTN Dissemination Librarians, 11/17/2008.

Andrews, Siara search
Delucchi, Kevin L. search mail
Greenberg, Brian search
Guydish, Joseph R. search mail
Masson, Carmen L. search mail
Shopshire, Michael search mail
Sorensen, James L. search mail

Supported by a grant from the National Institute on Drug Abuse to the University of Washington Alcohol and Drug Abuse Institute.
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