Selected in-treatment outcomes of long-term methadone maintenance treatment patients in New York State.

The New York State Office of Alcoholism and Substance Abuse Services (OASAS) licenses the largest system of methadone maintenance clinics nationwide. In 1996, a survey was undertaken to evaluate the functioning of patients continuously active in treatment for ten or more years. Information was obtained on a 10% random sample from the OASAS client data system and the records of the clinics. Data were collected concerning methadone dose, illicit drug and problematic alcohol use, employment, criminal activity, health, living situations, and the primary type of payment for treatment. A contrast group was constructed of discharged patients who had no more than 5 years of continuous treatment. The long-term active patients in the study sample showed superior outcomes on all variables, although some of the differences were small. However, the arrest rate for the discharged contrast group was 20 times as large as the arrest rate for the active study sample. These results are consistent with nationwide evaluations of methadone maintenance treatment. Factors that negatively impacted on the adjustments of the active patients were heavy use of crack/cocaine and disabilities. The long-term active patients in this sample belong to distinct subgroups with different levels of functioning, achievement, and ongoing health and social needs that must be investigated and addressed.