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Research Summary

Interim Methadone versus Standard Methadone: No Differences in Treatment Outcomes at 4 Months

Interim methadone (IM) was designed as an option to initiate methadone among opioid-dependent patients in the absence of scheduled psychosocial services rather than putting them on a waiting list for standard methadone (SM) treatment, which includes counseling. The aim of this randomized clinical trial was to determine if the absence of regular counseling had an adverse effect on methadone treatment outcomes at 4 months. Two hundred thirty participants were randomized to IM, SM, or restored methadone (RM*).

  • Patients in the IM condition received a mean of 0.7 counseling sessions over the study period, while patients in the SM and RM conditions received 8.4 sessions and 17.7 sessions, respectively.
  • There was no difference in treatment retention between groups (IM=92%, SM=81%, and RM=89%).
  • There was no difference in heroin use outcomes between groups. All 3 reported 29 days of use in the prior 30 days at baseline, which decreased to 3.3, 5.5, and 3.0 days in the IM, SM, and RM groups, respectively.

*RM=SM plus meetings with a counselor who had a reduced caseload.

Comments:

Although the frequency of counseling in the SM group was low and all IM patients were eventually transitioned to SM, these findings suggest that, in resource-limited settings where methadone treatment wait lists are common, IM is a reasonable alternative. Jeanette M. Tetrault, MD

Reference:

Schwartz RP, Kelly SM, O'Grady KE, et al. Interim methadone treatment compared to standard methadone treatment: 4-Month findings. J Subst Abuse Treat. 2011;41(1):21–29.

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