TY  - JOUR
T1  - MOderate- vs high-dose methadone for opioid dependence
AU  - Grabowski J, Creson D, Rhoades HM, Schmitz JM
Y1  - 1999/12/08
N1  - 10-1001/pubs.JAMA-ISSN-0098-7484-282-22-jbk1208
JO  - JAMA
SP  - 2121
EP  - 2123
VL  - 282
IS  - 22
N2  - 
In a large clinical trial, we demonstrated that low treatment doses
and a requirement that patients attend clinic 5 days per week negatively affected
retention rates dramatically. Yet, standard care in the United States demands
even more stringent requirements of patients than our trial imposed. These
requirements originated when the regulations governing the use of methadone
to treat heroin users was established. These provisions require patients to
visit clinics 7 times per week for the first 90 days. In our study, 3 other
groups—those who received 50 mg/d of methadone sodium and made 2 visits
per week, those who received 80 mg/d and made 5 visits per week, and those
who received 80 mg/d and made 2 visits per week—were equally successful
in remaining in treatment. Thus, retention is modulated by either dose or
by number of clinic visits required. However, those in both groups that received
80 mg/d of methadone had a lower proportion of opioid-positive urine samples
than the 2 groups receiving 50 mg. Higher methadone dose is more effective
for its intended and singularly direct effect on reducing illicit opioid use.
In another large randomized clinical trial designed to address treating those
addicted to cocaine with fluoxetine hydrochloride, we not only found the treatment
ineffectual, but we also demonstrated that the requirement for a high number
of clinic visits had a severely negative effect on treatment retention.3

SN  - 0098-7484
M3  - doi: 10-1001/pubs.JAMA-ISSN-0098-7484-282-22-jbk1208
UR  - http://dx.doi.org/10-1001/pubs.JAMA-ISSN-0098-7484-282-22-jbk1208
ER  -