Methadone Maintenance to Abstinence

This study imposed a set of decision rules to review and compare methadone maintenance detoxification research results in three 5-year eras since 1970. Variables of interest were detoxification completion rates, relative completion rates with and without program review and approval, psychotherapy, new pharmacological agents to accelerate the detoxification process, and abstinence rates at follow-up as a function of such treatment variables. The review found progressive improvement in overall detoxification completion rates over the three 5-year eras: 39.7%, 54.9%, and 76.3%. Program-recommended detoxification showed much higher completion rates than did unrecommended detoxification in 1970-1975 and psychotherapy-assisted detoxification showed modest but consistently greater completion rates in the two eras during which it was studied, 1970-1975 and 1976-1980. The consistent gains in detoxification completion rates over the three eras are attributed primarily to the use of new drugs which greatly shorten the detoxification interval and ameliorate withdrawal symptoms. The drugs do not appear to have had an effect on follow-up abstinence rates. Limitations upon the conclusions and generalizability of findings are discussed. Suggestions are made for future methadone maintenance detoxification treatment and research.