IMPROVEMENTS IN RETENTION RATES AND CHANGES IN CLIENT GROUP WITH METHADONE-MAINTENANCE STREAMING

This study evaluated changes in client population and in retention rat es following the introduction of a system of methadone maintenance str eaming. A low intervention and low supervision stream was combined wit h two abstinence-orientated streams. Privileges of take-home doses and local pharmacy dose collection were contingent on successful particip ation in the abstinence-orientated streams. The clinic also modified p olicy to allow clients greater control over dose levels, The case note s of the first 100 clients entering the programme in the year prior to the changes (1991) and in the year following the changes (1993) were compared, The results showed a significant increase in retention rates . The demographic and heroin using histories did not change, but the n ewer programme attracted a greater proportion of clients with no previ ous history of methadone maintenance treatment, Mean clinic dose incre ased from 45 mg to 63 mg when clients were allowed to exert control ov er dose. These findings reveal improved outcomes in a public methadone maintenance programme as a result of policy changes designed to give clients greater control of their treatment.