THE EFFECT OF INTAKE PROCEDURES ON PERFORMANCE IN METHADONE-MAINTENANCE

The effect of assessment and intake procedures on the outcome of metha done maintenance treatment was investigated in a natural experiment in which a single methadone clinic admitted 89 patients by a rapid intak e procedure, and 74 patients who had been on a waiting list and underw ent formal assessment interviews. Outcome measures were frequency of i llicit drug use as detected by urine tests, and risk of dropping out o r being expelled from treatment. Subjects admitted after prolonged, fo rmal assessment were more likely to be expelled, and were more than tw ice as likely to leave during the first 400 days of maintenance treatm ent (95 % Cl relative risk 1.1 to 5.2). The odds of formally assessed subjects using heroin in the first 6 months of treatment were twice th ose of the rapid intake group (95 % Cl odds ratio 1.5 to 2.2). The for mal assessment process deterred half the initial applicants, yet seems to have either selected individuals with a worse prognosis or to have had a negative effect on in-treatment performance