Retention in Methadone Treatment: Examining Relationships Between Methadone Dose and Length of Stay Using the Alcohol and Drug Services Study (ADSS)

• Activity Number: 152
• Type: Topic Contributed
• Date/Time: Monday, August 9, 2004 : 2:00 PM to 3:50 PM
• Sponsor: Section on Government Statistics
• Author(s): Lev S. Sverdlov*+ and Thoms M. Brady and Sameena M. Salvucci and Ping Yu and Hannah Kyeyune and Sameer DeSale and Emmanuel Sikali and Serge Sverdlov
• Companies: Synectics for Management Decisions, Inc. and Substance Abuse and Mental Health Services Administration and Synectics for Management Decisions, Inc. and Synectics for Management Decisions, Inc. and Synectics for Management Decision, Inc. and Synectics for Management Decision, Inc. and Synectics for Management Decision, Inc and Independent Researcher
• Keywords: substance abuse ; regression analysis ; methadone treatment ; factor analysis ; length of stay (LOS) ; survival analysis

Abstract

The years 1992 and 2000 saw a 40% increase in U.S. treatment episodes associated with heroin abuse. Effective methadone treatment for these clients is critical. This study explores factors affecting retention in treatment--an important measure of effectiveness--among clients discharged from outpatient methadone treatment, using the Substance Abuse and Mental Health Services Administration's nationwide Alcohol and Drug Services Study. The factors associated with length of stay (LOS) were studied using regression, survival, and factor (principal components) analyses. The average LOS was 555.0 days (n=428; N=109,973). In the three-dimensional space created by the methadone dose two weeks after treatment admission, duration of heroin addiction, and LOS, LOS had a complex configuration suggesting the presence of hidden factors associated with retention. Factor analysis of clinical, demographic, and social variables identified five factors (using the mineigen criterion) indicating differential associations of LOS with each of these. The paper will discuss the results of analyses with regard to the problem of individualization of methadone dose and optimization of the effectiveness.