Premature Discharge from Methadone Treatment: Patient Perspectives‪.‬

Methadone treatment has been a mainstay of the U.S. drug abuse treatment system since its inception in the mid-1960s (Dole & Nyswander 1965) and today there are approximately 240,000 patients enrolled in such programs. These programs have been subjected to a large number of studies (Schwartz et al. 2006; Strain et al. 1999; Platt et al. 1998; Metzger et al. 1993; Ball & Ross 1991), and treatment service providers (Deck & Carlson 2005; Jackson 2002; Simpson & Sells 1983). Data from four large-scale, multisite longitudinal studies conducted over the past 30 years have yielded fairly consistent 12-month methadone program retention rates, ranging from 40% (Simpson & Sells 1983) to 34% (Hubbard et al. 1989) and 54% (Simpson et al. 1997). Thus, the majority of patients enrolled in this "long-term treatment" drop out within the first year, leaving considerable room for improvement. Improving retention in methadone treatment is quite important as it has been shown that longer retention in treatment is associated with better patient outcomes and that the first year of treatment is critical (Hartel & Shoenbaum 1998; Simpson et al. 1997; Simpson & Sells 1983).