Implementation of a clinic policy of client-regulated methadone dosing

Elias Robles, Forrest B. Miller, Karen K. Gilmore-Thomas, Donald E. McMillan

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

A six-month interval (baseline) during which methadone doses above 99 mg required individual approval by the clinic's physician was compared with the subsequent 16-month period in which a policy of patient-regulated methadone dosing with no preset upper limit was implemented. During the later phase, all patients were required to remain at each selected dose for a minimum of four days, and standard compliance-based take-home dosing procedures were followed. For patients in the study sample (n=57), the daily maximum methadone dose increased from 165 mg during baseline to 300 mg during the self-regulation period, while their average daily methadone dose increased from 76.84 mg to 80.04 mg (W=473, n=57, p=0.01). Monthly percent of opiate-positive urine specimens decreased significantly from 5.26% during baseline to 1.64% during the self-regulated dose period (W=169, n=57, p<0.01), and use of other drugs remained unchanged. No patient failed to show possession of recalled take-home doses, and no instances of liquid methadone diversion were reported by law enforcement agencies in the area.

Original languageEnglish (US)
Pages (from-to)225-230
Number of pages6
JournalJournal of Substance Abuse Treatment
Volume20
Issue number3
DOIs
StatePublished - Jul 4 2001
Externally publishedYes

Keywords

  • Dosing
  • Methadone
  • Opiates
  • Self-regulation
  • Titration

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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