Identifying methadone maintenance clients at risk for poor treatment response: pretreatment and early progress indicators

Exhaustive searches have uncovered few demographic or other pretreatment fa ctors that reliably predict performance in substance abuse treatments. In t his study we evaluate whether early treatment response offers improved pred iction of treatment response 6 and 9 months later. New admissions to methad one maintenance treatment (n = 59) were dichotomized into outcome groups ba sed on treatment retention and ongoing drug use as revealed by urinalysis r esults 6 and 9 months after admission. Regression analyses revealed two ear ly (week 2) performance measures, counseling attendance and opiate abstinen ce, could be used to correctly classify the outcomes of more than 80% of th e sample. Strikingly, of the 20 participants who neither submitted an opiat e-negative urine sample in week 2 nor attended at least two scheduled couns eling sessions by that time, not one achieved a superior 6-month outcome. T he odds of having a superior outcome increased considerably for those who s ubmitted two opiate negative urine samples and attended two counseling sess ions by week 2. Thus, 6-month outcomes were well predicted by treatment per formance in week 2. Similar results are reported for month 9 outcomes. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.