METHADONE-MAINTENANCE OUTCOME AS A FUNCTION OF DETOXIFICATION PHOBIA

Objective: Methadone maintenance outcome as a function of detoxificati on phobia was examined. Method: Opiate addicts (N=271) in a 1983 rando m sample of methadone maintenance patients from three diverse populati ons were studied. Subjects from an individually assessed follow-up sam ple (N=102) were compared on detoxification phobia. Logistic regressio n analysis yielded best predictors of the phobia. Results: Phobic pati ents were more likely to be white, female, and abstinent; to have had fewer detoxification attempts and longer periods on maintenance; to sh ow persistence of the phobia; to meet diagnostic criteria for depressi ve or anxiety disorders; and to have Addiction Severity Index scores a bove the 75th percentile for psychological problems. Conclusions: Deto xification phobia has a complex relationship to methadone maintenance outcome. It is associated with greater abstinence for patients in meth adone maintenance treatment. However, for rehabilitated phobic patient s it presents a barrier to successful detoxification and a drug-free a djustment that is often associated with other psychopathology but coul d be ameliorated by targeted assessment and treatment.