The objective of this project is to advance current knowledge about the effectiveness of methadone maintenance treatment. Although the clinical efficacy of methadone maintenance has been established, the association between favorable patient outcomes and specific treatment services has not been demonstrated. Therefore, this project is designed to ascertain which patients profit most (and least) from methadone maintenance and to identify those aspects of the treatment programs which effect the desired changes. The research plan involves the collection of client outcome data on 2,400 admissions as well as on-site study of the provision of treatment services in 12 programs in five Easter states. All data will be collected by the project staff. Client characteristics and outcome will be measured with the Addiction Severity Index (ASI) at four periods - at admission, at 3, 6 and 24 months post-admission. Two successive cohorts of 1,200 admissions will be interviewed and tracked. Cohor II findings will validate Cohort I data and also provide for hypothesis testing. On-site study of the 12 treatment programs will classify, describe and measure treatment resources and the delivery of services. Three schedules will be employed to ascertain: (A) treatment resources and procedures, (B) types and extent of services actually provided, and (C) specific services provided to the 2,400 cohort patients (linkage data). Statistical analysis of the client and program data are planned to: (1) ascertain the extent to which clients improve during and after methadone maintenance treatment; (2) determine how treatment services are organized and delivered; and (3) determine which treatment procedures and services are more effective and which are less effective.
