Question 5: Does methadone maintenance treatment improve the likelihood of obtaining and retaining employment?
Answer: Yes. The likelihood of becoming and remaining employed is increased for patients who participate in methadone maintenance treatment.
Research Highlights
- In an early study of 100 chronic heroin users who were admitted to methadone maintenance treatment, the employment rate increased from 21 percent at admission to 65 percent 1 year later (Maddux and Desmond, 1979).
- A study of 92 males admitted to methadone maintenance treatment programs from 1971 through 1973 demonstrated that, following methadone maintenance treatment, employment increased about 18 percent (Harlow and Anglin, 1984).
- In a 10-year followup study, 95 chronic opioid users who spent at least 1 cumulative year in methadone maintenance treatment were compared with 77 chronic opioid users who spent less than 1 cumulative year in methadone maintenance treatment. Those who were on methadone maintenance treatment for more than 1 year had a higher average time employed (mean of 42 months) than those who were in treatment for less than 1 year (mean of 35 months) (Maddux and Desmond, 1992).
- The Powers and Anglin (1993) study of 933 heroin addicts in methadone maintenance treatment demonstrated that rates of employment (and marriage) increased during treatment.
- Methadone maintenance patients in the Treatment Outcome Perspective Studies (TOPS) had small changes in employment rates during and following treatment compared with pretreatment rates. Although 24 percent of the patients reported full-time employment in the year before admission, this rate did not increase significantly during treatment. It declined abruptly in the 3 months following discharge, improved to 29 percent by year 2, and dropped off again to less than pretreatment rates by years 3 to 5 following treatment (Hubbard, Marsden, Rachal, et al., 1989).
- In a study that compared ongoing methadone maintenance with 6 months of methadone maintenance followed by detoxification, no difference was seen in employment, although nearly 50 percent of patients were employed at entry into the study (McLellan, Arndt, Metzger, et al., 1993).
Changes in Employment During and After Methadone Maintenance Treatment–Figures 19 and 20 illustrate the effects of methadone maintenance treatment on full-time employment as demonstrated by the TOPS and DARP studies. In one study, there was little effect, but in the other, methadone maintenance treatment was associated with significant increases in full-time employment.
Figure 19 illustrates that patients in TOPS studies
experienced small and inconsistent changes in
full-time employment rates during and after treatment.
Employment rates were about 24 percent 1 year
before treatment, ranged from 20 to 25 percent
during the first year after treatment, rose to
29 percent during the second year after treatment,
and declined to 18 percent 3 to 5 years after treatment
In contrast, Figure 20 illustrates that the DARP
studies reported an abrupt increase from
33-percent full-time employment before
treatment to nearly 60 percent after treatment
(Simpson and Sells, 1982).
References
Abbott PJ, Moore B, Delaney H, Weller S. Retrospective analyses of additional services for methadone maintenance patients. Journal of Substance Abuse Treatment 1999;17(1-2):129-37.
Harlow LL, Anglin MD. Time series design to evaluate effectiveness of methadone maintenance intervention.Journal of Drug Education 1984;14(1):53-72.
Hubbard RL, Marsden ME, Rachal JV, Harwood HJ, Cavanaugh ER, Ginzburg HM. Drug Abuse Treatment: A National Study of Effectiveness. Chapel Hill: University of North Carolina Press, 1989.
Maddux JF, Desmond DP. Crime and treatment of heroin users. The International Journal of the Addictions1979;14(7):891-904.
Maddux JF, Desmond DP. Ten-year follow-up after admission to methadone maintenance. American Journal of Drug and Alcohol Abuse 1992;18(3):289-303.
Maddux JF, McDonald LK. Status of 100 San Antonio addicts one year after admission to methadone maintenance.Drug Forum 1973;2:239-52.
McLellan AT, Arndt IO, Metzger DS, Woody GE, O'Brien CP. The effects of psychosocial services in substance abuse treatment. JAMA 1993;269(15):1953-59.
Powers KI, Anglin MD. Cumulative versus stabilizing effects of methadone maintenance. Evaluation Review1993;17(3):243-70.
Sees KL, Delucchi KL, Masson C, Rosen A, Clark HW, Robillard H, et al. Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence. A randomized controlled trial. JAMA2000;283:1303-10.
Simpson DD, Sells SB. Effectiveness of treatment for drug abuse: an overview of the DARP research program.Advances in Alcohol and Substance Abuse 1982;2(1):7-29
In This Section
- Certificate Programs
- Methadone Research Web Guide
- Acknowledgments
- Introduction
- Part A
- Part B
- Question 1: Is methadone maintenance treatment effective for opioid addiction?
- Question 2: Does methadone maintenance treatment reduce illicit opioid use?
- Question 3: Does methadone maintenance treatment reduce HIV risk behaviors and the incidence of HIV infection among opioid-depen
- Question 4: Does methadone maintenance treatment reduce criminal activity?
- Question 5: Does methadone maintenance treatment improve the likelihood of obtaining and retaining employment?
- Question 6: What effect can methadone maintenance treatment have on the use of alcohol and other drugs?
- Question 7: What components of methadone maintenance treatment account for reductions in AIDS risk behaviors?
- Question 8: Do risk factors for HIV infection acquisition and transmission differ for women compared with men in methadone maint
- Question 9: Is methadone maintenance treatment effective for women?
- Question 10: Is methadone safe for pregnant women and their infants?
- Question 11: Is it necessary to reduce methadone dose or detoxify women from methadone during pregnancy to protect the f
- Question 12: Is the long-term use of methadone medically safe, and is it well tolerated by patients?
- Question 13: Are there program characteristics associated with the success of methadone maintenance treatment?
- Question 14: Are there patient characteristics associated with the success of methadone maintenance treatment?
- Question 15: Are there cost benefits to methadone maintenance treatment?
- Question 16: What are the retention rates for methadone maintenance treatment?
- Question 17: Is mandated methadone maintenance treatment as effective as voluntary treatment?
- Question 18: What is the role of L-alpha-acetyl-methadol (LAAM)?
- Question 19: How do buprenorphine and methadone compare?
- Question 20: Can methadone and buprenorphine be abused?
- Part C
- Part D
- Methadone Research Web Guide Tutorial
- Questions: Methadone Research Web Guide
- Answers: Methadone Research Web Guide
- Methadone Research Web Guide
- Degree Programs
- Virtual Lectures
- Research Publications
Important Dates
NIDA International Forum
June 14–17, 2013
Online Registration Deadline:
May 6, 2013
FELLOWSHIPS
IAS/NIDA Fellowships
Application Deadline:
February 10, 2013
NIDA International Program Fellowships
Application Deadline:
April 1, 2013
Global Health Program for Fellows and Scholars
Application Deadlines: Vary
GRANTS
Brain Disorders in the Developing World: Research Across the Lifespan
(Non-AIDS)
R01 PAR-11-030and R21 PAR-11-031
Application deadline:
February 14, 2013
MEETINGS
American Association for the Advancement of Science
February 14–18, 2013
Boston, Massachusetts, USA
International Drug Abuse Research Society (IDARS)
April 15–19, 2013
Mexico City, Mexico
2013 International Conference on Global Health: Prevention and Treatment of Substance Abuse and HIV
April 17–19, 2013
Taipei, Taiwan
Yih-Ing Hser, Ph.D.