Comparative drug use and psychosocial profiles of opioid dependents applying for medication versus medication?free treatment

Abstract

Drug treatment?seeking abusers generally self?select their treatment modality. Most opioid?dependent individuals select either methadone maintenance or detoxification followed by medication?free outpatient treatment. This study examined demographic, drug use, and drug abuse treatment history for opioid dependent patients entering an opioid agonist (n = 203) or a medication?free (n = 155) treatment program located on the same hospital campus. Similar demographic profiles support the assertion that samples were drawn from the same inner city urban opioid using population. Patients entering drug?free treatment, however, reported more extensive prior use of both cocaine and alcohol. Further, these patients had a generally more severe profile of psychosocial problems in medical, legal, employment, family/social, and psychiatric areas as measured by the Addiction Severity Index (ASI). These findings suggest that outpatient drug?free programs enrolling opioid abusers are faced with a unique service delivery challenge that involves service needs in multiple arenas. The findings further suggest that patient self?selection of treatment programs may in some cases result in a discrepancy between patient needs and the ability of treatment programs to retain patients and deliver an appropriate array of services.