Retention of patients who entered methadone maintenance via an interim methadone clinic

FRANÇAIS :
De 1990 à 1991, 314 héroïnomanes admis au programme méthadone intermédiaire de la "Beth Israel Clinic" sont comparés aux 663 héroïnomanes du programme traditionnel. Les caractéristiques démographiques ne diffèrent pas d'un groupe à l'autre (sexe masculin, âge moyen 35 ans...). L'assiduité au traitement est quasiment la même dans les deux groupes. Seule une différence de 6 à 7%, au bénéfice du programme traditionnel, est relevée dès le deuxième mois, qui n'augmentera pas jusqu'à la fin du traitement (12ème mois). Les auteurs concluent donc qu'il faudrait multiplier ces traitements intermédiaires qui permettent de réduire les risques d'infection VIH chez ces patients à risque qui ne peuvent attendre trop longtemps l'inscription aux programmes traditionnels.
ENGLISH :
Time in treatment is considered an important predictor of good outcomes for drug abuse treatment. Patient retention would be of particular concern for low-services types of treatment. Interim methadone maintenance was developed as an alternative to waiting lists and as a method of providing HIV risk-reduction services to heroin addicts waiting for treatment, and does not include the regular counseling required in comprehensive methadone treatment. This analysis compares the retention of patients first admitted to an interim methadone clinic versus that of patients admitted directly to a comprehensive methadone clinic. The two groups did not differ with regard to demographic characteristics and drug of abuse at the time of admission. Life-table analysis revealed that the two groups did not differ significantly with regard to retention (p=0.17). Interim treatment does not appear to adversely affect overall retention in treatment. Three-and six-month retention rates of interim clinic patients fall within the range of six-month nationwide retention rates reported by the GAO. Factors associated with discharge from treatment are examined for both groups. (From authors' abstract)