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Improvements in Outcomes in Methadone Patients on Probation/Parole Regardless of Counseling Early in Treatment

Kelly, Sharon M. PhD; O'Grady, Kevin E. PhD; Jaffe, Jerome H. MD; Gandhi, Devang MD; Schwartz, Robert P. MD

Journal of Addiction Medicine:
doi: 10.1097/ADM.0b013e318284a0c1
Original Research
Abstract

Objective: This secondary data analysis examined the association between criminal justice (CJ) status and outcomes over 12 months of methadone maintenance treatment.

Methods: In the parent study, 230 newly admitted patients were randomly assigned to methadone either with or without counseling for 4 months followed by standard methadone with counseling. Participants completed the ASI and urine drug testing at baseline and 4- and 12-month follow-up and the Treatment Readiness (TR) scale at baseline. The relationship between baseline CJ status (whether participants were on probation or parole), CJ status by study counseling condition, and CJ status by TR with heroin and cocaine use, illegal activity, days in treatment and treatment retention, arrests, and the number of days incarcerated or hospitalized during follow-up was examined.

Results: Compared with participants not on probation/parole, probationers/parolees showed significant reductions in cocaine-positive tests from baseline to 12 months (P < 0.001). Probationers/parolees additionally reported significantly fewer days of illegal activity than nonprobationers/parolees at 12 months (P = 0.02). There was no relationship between CJ status and counseling condition for any outcomes. The relationship between CJ status and TR was significant only for cocaine-positive tests assessed over time (P = 0.017).

Conclusions: Findings suggest that methadone participants on probation/parole showed improvements in outcomes in comparison with participants not on probation/parole, regardless of whether they received counseling during the first 4 months of treatment.

Author Information

From the Friends Research Institute (SMK, JHJ, RPS), Baltimore, MD; University of Maryland (KEO), College Park; and University of Maryland School of Medicine (JHJ, DG, RPS), Baltimore.

Send correspondence and reprint requests to Sharon M. Kelly, PhD, Friends Research Institute, Inc., 1040 Park Avenue, Suite 103, Baltimore, MD 21201. E-mail: skelly@friendsresearch.org.

Supported by the National Institute on Drug Abuse grant 2R01DA13636 titled “Entry Into Comprehensive Methadone Treatment via Interim Maintenance” (PI Schwartz) and by The Abell Foundation, which provided support for the counselor position in the Restored Methadone condition. The content is solely the responsibility of the authors and does not necessarily represent the official views of NIDA or The Abell Foundation.

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the manuscript.

Received September 05, 2012

Accepted December 23, 2012

© 2013 American Society of Addiction Medicine