Abstract
The authors evaluated the effects on retention and other outcomes of three approaches in a methadone maintenance program. At the time of admission, 300 chronic opioid users were randomly assigned to standard treatment, patient-regulated dose, or optional counseling. Retention of the optional counseling group exceeded that of the other two groups, but the difference was only of borderline significance. Allowing patients to regulate their methadone dose did not lead to a general escalation of dose. Subjects in optional counseling saw their counselors less than half as often as those in the standard treatment with two mandatory sessions per month. Illicit drug use and social performance in the twelfth month did not differ significantly among the three subgroups that remained in treatment. The findings support patient participation in decisions about methadone dose and the frequency of counseling.