PATIENT-REGULATED METHADONE DOSE AND OPTIONAL COUNSELING IN METHADONE-MAINTENANCE

The authors evaluated the effects on retention and other outcomes of t hree approaches in a methadone maintenance program. At the time of adm ission, 300 chronic opioid users were randomly assigned to standard tr eatment, patient-regulated dose, or optional counseling. Retention of the optional counseling group exceeded that of the other two groups, b ut the difference was only of borderline significance. Allowing patien ts to regulate their methadone does did not lead to a general escalati on of dose. Subjects in optional counseling saw their counselors less than half as often as those in the standard treatment with two mandato ry sessions per month. Illicit drug use and social performance in the twelfth month did not differ significantly among the three subgroups t hat remained in treatment. The findings support patient participation in decisions about methadone dose and the frequency of counseling.