RAPID ADMISSION AND RETENTION ON METHADONE

An open clinical trial was conducted to compare the effects of rapid ( 1-day) admission with slow (14-day) admission to methadone maintenance on pretreatment attrition, retention during treatment, and other outc omes. One hundred eighty-six illicit opioid users eligible for methado ne maintenance were randomly assigned to rapid admission or slow admis sion, with 93 subjects assigned to each group. The random assignment p roduced two groups that were similar on 22 personal variables. All sub jects admitted to treatment were followed for 1 year. Follow-up interv iews were obtained with 155 (98%) of the 158 subjects admitted to trea tment. During the period from initial contact to medication, only 4% o f the rapid admission subjects but 26% of the slow admission subjects dropped out. The risk of dropout during slow admission was 6 times tha t during rapid admission. A higher percentage of rapid admission subje cts, 43%, than of slow admission subjects, 39%, remained continuously in treatment for 1 year, but the difference was not significant. The t wo subgroups that remained in treatment for 1 year did about equally w ell on measures of illicit drug use and social performance. The findin gs indicate that pretreatment attrition can be markedly reduced by pro mpt medication, and that prompt medication does not adversely affect r etention during treatment or other outcomes.