Shutting off methadone. Costs and benefits.

We report the findings of a two-year follow-up of the 99 methadone clients enrolled in the Bakersfield, Calif, clinic when it was closed in September 1976. Because of the remote location, only 11 transferred to another clinic. A sample of 88 were selected from a continuing program for comparison. Ninety-five percent of the combined samples were interviewed. Fifty-four percent of the terminated clients became readdicted to heroin, and the arrest and incarceration rates were approximately double that for the comparison sample. The simultaneous initiation of a special police narcotic task force may have contributed to the arrest rate and limited the percent of time addicted. The net economic costs subsequent to discharge were slightly less than that for the comparison group; however, when the benefits resulting from new admissions are considered, the clinic closing represented an economic loss in addition to the detrimental effects experienced by the clients.