Patterns of illicit drug use and retention in a methadone program: A longitudinal study

Ingrid Davstad, MA; Marlene Stenbacka, PhD; Anders Leifman, MSE; Olof Beck, PhD; Seher Korkmaz, MD, PhD; Anders Romelsjo, MD, PhD

doi:10.5055/jom.2007.0036

Authors

Ingrid Davstad, MA
Marlene Stenbacka, PhD
Anders Leifman, MSE
Olof Beck, PhD
Seher Korkmaz, MD, PhD
Anders Romelsjo, MD, PhD

DOI:

https://doi.org/10.5055/jom.2007.0036

Keywords:

methadone maintenance treatment, urine samples, drug abuse patterns, discharge, drug abuse, methadone dose

Abstract

Objective: This study aimed to analyze illicit drug use of participants in a methadone treatment program in relation to methadone dose, counseling, and retention.
Methods: This was a longitudinal study of a cohort of 204 heroin-dependent subjects admitted for the first time to a methadone program in Stockholm. The patients were admitted between 1995 and mid-2000 and were followed until December 2000 or discharge. Up to June 11, 1998, individual psychosocial counseling was provided; after this date individual counseling was replaced with group counseling. Clinical data were collected from patient records and from a laboratory database. Rates of drugpositive urine analyses during different time periods were measured.
Results: The mean observation time was 2.5 years for all patients. The one-year retention rate was 84 percent, and the two-year rate was 65 percent, with no major differences between the two counseling groups. Almost all patients relapsed to illicit drug use. Discharged patients had a significantly higher rate of positive urine samples (21 percent versus 9 percent) than patients who remained in treatment. Also, low methadone dose and younger age predicted discharge from treatment.
Conclusion: The frequent urine monitoring showed that illicit drug use was rather common, even in a program with structured psychosocial interventions, although it was lower than in other studies. This testing policy can be used for early identification of patients at risk for drop-out or discharge who should be offered complementary interventions.

Author Biographies

Ingrid Davstad, MA

Stockholm Addiction Centre, Magnus Huss, Stockholm, Sweden; Karolinska Institute, Department of Public Health Sciences, Magnus Huss, Stockholm, Sweden.

Marlene Stenbacka, PhD

Stockholm Addiction Centre, Magnus Huss, Stockholm, Sweden; Karolinska Institute, Department of Public Health Sciences, Magnus Huss, Stockholm, Sweden; Karolinska Institute, Department of Clinical Neuroscience, Magnus Huss, Stockholm, Sweden.

Anders Leifman, MSE

Stockholm Addiction Centre, Magnus Huss, Stockholm, Sweden; Karolinska Institute, Department of Clinical Neuroscience, Magnus Huss, Stockholm, Sweden.

Olof Beck, PhD

Karolinska Institute, Department of Medicine, Division of Clinical Pharmacology, Karolinska Hospital, Stockholm, Sweden.

Seher Korkmaz, MD, PhD

Karolinska Institute, Department of Medicine, Division of Clinical Pharmacology, Karolinska Hospital, Stockholm, Sweden.

Anders Romelsjo, MD, PhD

Karolinska Institute, Department of Public Health Sciences, Magnus Huss, Stockholm, Sweden; Centre for Social Alcohol and Drug Research, Stockholm University, Stockholm, Sweden.

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