![]() ![]() ![]() These programs have been subjected to a large number of studies ( Schwartz et al. Methadone treatment has been a mainstay of the US drug abuse treatment system since its inception in the mid 1960s ( Dole & Nyswander 1965) and today there are approximately 240,000 patients enrolled in such programs. Patient-centered program and policy implications are discussed. An analysis of the patterns of agreement and disagreement are presented. Patients’ reasons for discharge were compared to counselors’ reasons as indicated in discharge summary forms. The former factors are richly described through patients’ words and underscore the ways in which patients’ perceptions of control exerted by the program and by the medication and misunderstandings of program structure can lead to premature discharge. The two most consistent themes are program-related factors and incarceration. Through an examination of 42 qualitative interviews with patients prematurely discharged from six methadone treatment programs in Baltimore, this paper highlights factors patients describe as contributing to their reasons for being discharged within the first 12 months of the treatment. Nevertheless, large-scale multi-site longitudinal studies over the past three decades indicate that the majority of patients drop out during the first year of methadone treatment. Longer retention in drug abuse treatment is associated with better patient outcomes and research indicates the first 12 months of methadone treatment are critical to patient success.
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