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 TreatmentFigures 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 (Hubbard et al., 1989). 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.

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 shows 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).

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