Analysis of behavioral patterns in five cohorts of patients retained in methadone maintenance programs

Background: Various techniques have been devised to evaluate the effectiveness of long-term methadone maintenance treatment. Traditional comparative analysis of behavior patterns at the time of admission and discharge would be inappropriate, because the majority of patients leave the programs prematurely and under unfavorable circumstances. One approach has been to collect available data on patients who are actively undergoing methadone treatment. Methods: The sampling population for this study was limited to methadone maintenance patients in New York State who have remained in treatment for 1 - 6 years. Samples of active patients were drawn from five time-in-treatment cohorts (1 -2 years, 2-3 years, 3-4 years, 4-5 years and 5-6 years). A total of 673 patients were included in the study. Results: All five cohorts experienced significant reductions in the number of patients arrested, the number of patients incarcerated, and the number of days incarcerated per patient. Each cohort also experienced large reductions in arrests per patient and moderate increases in employment-related activities, although current rates of employment are still relatively low. A decreased number of child-protective cases were noted over time for those under treatment, along with higher rates of insurance and self-pay for treatment. The self-pay group, however, remained relatively small. No patterns were detectable in the areas of patient hospitalization or emergency room admissions, although the 5-6 year cohort experienced reductions on all measures. Conclusions: Some favorable changes in the behavior of patients are associated with long-term methadone treatment.