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Methadone maintenance was more effective for treatment retention for opioid dependence than psychosocially enriched detoxification
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 QUESTION: In adults with opioid dependence, do standard methadone maintenance (MM) and methadone assisted detoxification plus intensive psychosocial services lead to similar outcomes?

Design

Randomised {allocation concealed*}, unblinded,* controlled trial with 12 month follow up.

Setting

A Veterans Affairs medical centre in San Francisco, California, United States.

Patients

179 non-veteran adults who were ≥18 years of age (mean age 39 y, 59% men); had a diagnosis of opioid dependence according to the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition; and tested positive for opioid use and negative for methadone use. Exclusion criteria were contraindications to methadone treatment, psychiatric medical conditions that interfered with treatment, pregnancy, lactation, concurrent substance abuse treatment, no signs of opioid withdrawal on 3 occasions, methadone treatment in the previous week, participation in a follow up phase of a previous methadone detoxification research protocol, or inability to participate for …

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