A LOW-THRESHOLD METHADONE STABILIZATION PROGRAM - DESCRIPTION AND FIRST STAGE EVALUATION

A low threshold methadone stabilisation programme was set up to cater for the most chaotic clients seen in a central London Drug Dependence Clinic. It set out to reduce HIV risk behaviours, to stabilise drug us e and to move clients on to other forms of treatment. The programme wa s evaluated over the first two months and compared with a consecutive group of outpatients. The methadone programme group had failed more tr eatments and were more likely to be injecting and have a psychiatric h istory. They were engaging in higher risk injecting behaviour before e ntry to the programme and their level of injecting risk dropped signif icantly more than the comparison group in the first two months in the programme. There was no change in sexual risk. Using the HADS, the num bers of cases of depression dropped only in the methadone programme gr oup (Zigmund and Snaith 1983). The drop out rate was similar in both g roups. No demographic or history variables were found to be associated with drop out. It was concluded that the methadone programme was usef ul for a difficult group of clients but a failure to retain more clien ts than conventional outpatients may be related to methadone dose.