TY - JOUR
T1 - Involuntary versus voluntary detoxification from methadone maintenance treatment
T2 - The importance of choice
AU - Knight, Kelly R.
AU - Rosenbaum, Marsha
AU - Irwin, Jeanette
AU - Kelley, Margaret S.
AU - Wenger, Lynn
AU - Washburn, Allyson
N1 - Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 1996
Y1 - 1996
N2 - The authors report on a subset of data from a three-year qualitative and quantitative study of 233 injection drug users (IDUs) in and out of methadone maintenance treatment (MMT) programs in the San Francisco Bay Area. We analyzed data from ten study participants detoxified from their MMT programs voluntarily and thirty involuntarily detoxified due to the defunding of their subsidized MMT slots. All of the study participants reported benefits from MMT program participation including decreased drug use or abstinence; decreased illicit activity; increased ability to maintain or initiate conventional employment; and increased ability to respond to parenting and family obligations. Those who were involuntarily detoxified from MMT programs experienced severe destabilization. Many were financially unstable and dependent on subsidized drug treatment prior to defunding. Several defunded participants were detoxified because they could not afford private fees ($225-300/month); others reverted to illicit activities to pay clinic fees. The majority increased heroin use, illicit activity, and experienced economic and personal harm as a result of involuntary detoxification from MMT. Those who chose to detoxify from MMT programs reported longer treatment histories and greater financial stability. Most described methadone as a prescription-like drug; ancillary clinic services, such as counseling, were unnecessary and undesired by many who voluntarily detoxified. Those who remained opioid-free reported that slow detoxifications from MMT, with client input and control, were necessary to prevent relapse. Study participants in this group who returned to the intermittent use of heroin had the financial resources to re-enroll in MMT. None of the voluntarily detoxified study participants returned to daily heroin use or illicit activity when leaving MMT programs.
AB - The authors report on a subset of data from a three-year qualitative and quantitative study of 233 injection drug users (IDUs) in and out of methadone maintenance treatment (MMT) programs in the San Francisco Bay Area. We analyzed data from ten study participants detoxified from their MMT programs voluntarily and thirty involuntarily detoxified due to the defunding of their subsidized MMT slots. All of the study participants reported benefits from MMT program participation including decreased drug use or abstinence; decreased illicit activity; increased ability to maintain or initiate conventional employment; and increased ability to respond to parenting and family obligations. Those who were involuntarily detoxified from MMT programs experienced severe destabilization. Many were financially unstable and dependent on subsidized drug treatment prior to defunding. Several defunded participants were detoxified because they could not afford private fees ($225-300/month); others reverted to illicit activities to pay clinic fees. The majority increased heroin use, illicit activity, and experienced economic and personal harm as a result of involuntary detoxification from MMT. Those who chose to detoxify from MMT programs reported longer treatment histories and greater financial stability. Most described methadone as a prescription-like drug; ancillary clinic services, such as counseling, were unnecessary and undesired by many who voluntarily detoxified. Those who remained opioid-free reported that slow detoxifications from MMT, with client input and control, were necessary to prevent relapse. Study participants in this group who returned to the intermittent use of heroin had the financial resources to re-enroll in MMT. None of the voluntarily detoxified study participants returned to daily heroin use or illicit activity when leaving MMT programs.
KW - Drug Policy
KW - Drug Treatment Funding
KW - Injection Drug Users
KW - Methadone Maintenance Treatment
UR - http://www.scopus.com/inward/record.url?scp=2842586094&partnerID=8YFLogxK
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U2 - 10.3109/16066359609005248
DO - 10.3109/16066359609005248
M3 - Article
AN - SCOPUS:2842586094
SN - 1606-6359
VL - 3
SP - 351
EP - 362
JO - Addiction Research and Theory
JF - Addiction Research and Theory
IS - 4
ER -