Narcotics research, rehabilitation, and treatment. Hearings, Ninety ...

124BESULTS(1) Although many of the patients test the methadone "blockade" of heroinone or more times in the first few months, less than 1 percent have returnedto regular heroin usage while under methadone maintenance treatment.(2) Antisocial behavior as measured by arrests and incarcerations (jail) havebeen looked at in several ways. First, the percentage of arrests among patientsin the program during the 3 years prior to admission was compared with the percentageof arrests of these same persons following admission. This "before andafter" picture is also contrasted with the proportion of arrests in a contrast groupof 100 men selected from the detoxification unit at Morris Bernstein Institutematched by age and ethnic group and followed in the same manner. The resultsare illustrated in figure 9. The arrest records of these two groups are quite similarfor each year of observation prior to admission. Following admission to theprogram, the contrast is striking for each period of observation with the methadonemaintenance patients showing a marked decrease in the percentage ofpatients arrested, and the contrast group showing a pattern very similar to theearlier period of observation.We have also calculated the arrests per 100 patient-years of observation for the3 years prior to admission in contrast to the arrests per 100 patient-years ofobservation after admission. We have compared these data using the same computationsfor the contrast group. The results are shown in table 5. These resultswould appear to indicate that remaining in the methadone maintenance programdoes indeed decrease antisocial behavior as measured by arrests or incarcerations.(3) Increased social productivity can best be illustrated by the employmentprofiles shown in figures 10 and 11. There is a steady and rather marked increaseii the employment rate with a corresponding decrease in the percentage ofpatients on welfare as time in the program increases. This is true both for themen and the women. These data include both ambulatory and inpatient inductiongroups. This accounts for the increased percentage of men employed at timeof admission since this was one of the early criteria for admission to an ambulatoryunit.(4) Figure 12^ is an attempt to illustrate stability of employment amongpatients remaining in the program as contrasted with their previous employmentexperience. The shaded area might be considered as a measure of their increasedsocial productivity since admission to the program.(5) Although chronic alcohol abuse continues to be a problem for approximately8 percent of the patients (both men and women), and for some becomesthe principal reason for discharge, a majority of these patients show continuedimprovement in their ability to handle their alcohol problem with the supportand assistance of members of the program staff who recognize the problem, and,are willing and able to cope with it.(6) Problems with chronic abuse of drugs such as barbiturates, amphetamines,and more recently cocaine are evident in approximately 10 percent of the patients.There again, for some, it has resulted in discharge from the program. For manyothets, the patients are able to function satisfactorily, with the assistance andsupport of members of the program staff.CONCLUSIONSOn balance, the successes in the methadone maintenance treatment programfar outweigh the failures. The rapid expansion of the program during the pastyear, and the change in emphasis to include primarily ambulatory inductionunder the expanded admission criteria does not appear to have made any noticeablechange in the effectiveness of this treatment for those heroin addicts whohave been accepted into the program. A majority of the patients have completedtheir schooling or increased their skills and have become self-supporting. Theirpattern of arrests has decreased substantially. This is in sharp contrast to theirown previous experience, as well as their current experience when compared witha matched group from the Detoxification unit, or when compared with thosepatients who have left the program. Less than 1 percent of the patients whohave remained in the program have reverted to regular heroin use.A small proportion of the patients (10 percent) persent continued evidence ofdrug abuse involving use of amphetamines, barbituarates, and cocaine, andanother 8 percent demonstrate continued problems from chronic alcohol abuse.These two problems account for the majority of failures in rehabilitatin after thefirst 6 months.