METHADONE DOSE AND TREATMENT OUTCOME

Consensus on the optimal dosing of methadone in the treatment of opioi d dependence has not yet been achieved, with some programs committed t o low dose regimens. This paper presents outcome results for 95 opioid abusers who remained in treatment through a stable dosing period in a double-blind fixed dose clinical trial comparing the relative efficac ies of 50 (n = 44) and 20 mg (n = 34) of methadone to methadone-free t reatment (n = 17). All patients showed improvements over time on measu res of psychosocial functioning and psychological symptoms, emphasizin g the important role of non-pharmacologic factors in methadone treatme nt. Furthermore, orderly dose effect relationships were seen, with pat ients receiving 50 mg of methadone having significantly lower rates of opioid positive urines (36% vs. 60 - 73%), and self-reporting a lower frequency of heroin use (3 days vs. 11 - 12 days per month). These re sults illustrate the dose-related efficacy of methadone in decreasing illicit opioid use and improving drug-related behavior.