Dosage Patterns in Methadone Treatment: Results from a National Survey, 1988–2005.

Objective. To examine the extent to which U.S. methadone maintenance facilities meet established standards for minimum dosages, 1988–2005. Data Source. Data were collected from a nationally representative sample of outpatient treatment facilities in 1988 ( n=172), 1990 ( n=140), 1995 ( n=116), 2000 ( n=150), and 2005 ( n=146). Study Design. Random-effects multiple regression analysis was used to examine unit characteristics associated with below recommended doses. Data Collection. Data regarding the proportion of patients who received maintenance dosages of <40, 60, and 80 mg/day were collected from unit directors and clinical supervisors. Principal Findings. Forty-four percent of patients receive doses of at least 80 mg/day—the threshold identified as recommended practice in recent work. Thirty-four percent of patients receive doses below 60 mg/day, while 17 percent receive doses below 40 mg/day. Units that serve a high proportion of African American or Latino clients were more likely to report low-dose care. Units managed by individuals who strongly favor abstinence models (e.g., Narcotics Anonymous) were more likely to provide low-dose care. Conclusions. One-third of methadone facilities provide doses below recommended levels. Managerial attitudes about abstinence and their relationship to low doses underscore the contested role of methadone in treatment of opiate disorders. [ABSTRACT FROM AUTHOR]