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To the Editor: Dr Strain and colleagues¹ addressed the importance of methadone sodium dose in retaining persons dependent on opioids in treatment. In addition to myriad lesser factors, 2 major reasons for patients to discontinue treatment are the level of doses given to patients and the number of times they are required to visit the clinic.²

In a large clinical trial, we demonstrated that low treatment doses and a requirement that patients attend clinic 5 days per week negatively affected retention rates dramatically. Yet, standard care in the United States demands even more stringent requirements of patients than our trial imposed. These requirements originated when the regulations governing the use of methadone to treat heroin users was established. These provisions require patients to visit clinics 7 times per week for the first 90 days. In our study, 3 other groups—those who received 50 mg/d of methadone sodium and made 2 . . . [Full Text of this Article]

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RELATED ARTICLE

Moderate- vs High-Dose Methadone in the Treatment of Opioid Dependence: A Randomized Trial
Eric C. Strain, George E. Bigelow, Ira A. Liebson, and Maxine L. Stitzer
JAMA. 1999;281(11):1000-1005.
ABSTRACT | FULL TEXT