Predictors of dropout from psychosocial treatment in opioid-dependent outpatients

Abstract

Background and objectives: Early dropout is common in substance abuse treatment settings and may lead to poorer outcomes relative to those completing a full course of treatment. Attempts to identify predictors of dropout have yielded mixed results, highlighting the need for additional research in this area to clarify risk and protective factors to guide intervention and retention efforts. This study evaluated predictors of dropout from psychosocial treatment among opioid-dependent patients on methadone maintenance therapy.

Methods: Participants included 78 patients who had failed to respond to at least 4 months of methadone maintenance plus group counseling with clinic substance abuse counselors, and were enrolled in a study of randomized psychosocial treatment in addition to treatment-as-usual. Several factors that have been implicated in previous studies as well as two affective variables (distress intolerance and coping motives for drug use) were examined.

Results: Results indicated that when controlling for various risk factors, age was the only significant predictor of dropout, with younger patients more likely to discontinue treatment early.

Conclusions: This study replicates previous findings in opioid-dependent samples that younger patients are at an increased risk of early treatment dropout.

Conclusions and significance: Targeted intervention may be needed to retain young patients in drug abuse treatment.

Conflict of interest statement

Declaration of Interest

The authors are aware of no conflicts with the content of this manuscript, nonetheless Dr. Otto would like to report past (3 years) consultant and research support from Organon (Merck), and royalties received for use of the SIGH-A from Lilly. Dr. Pollack would like to report past year advisory board and/or consultation from Brain Cells, Eli Lilly, Johnson and Johnson, Medavante, Labopharm, Mindsite, Sepracor, Targia Pharmaceuticals, Pfizer, research grants from Bristol Myers Squibb, Euthymics, Forest Laboratories, GlaxoSmithKline, Eli Lilly, NCCAM, NIDA, NIMH, and Sepracor, CME supported activities from Astra-Zeneca, Sepracor, and Pfizer, equity in Medavante, Mensante Corporation, Mindsite, and Targia Pharmaceuticals, and royalty and/or patent with the SIGH-A and SAFER interviews. Dr. McHugh would like to report consultant support in the past year from WebEBP and receipt of royalties from Oxford University Press. The other authors have no relevant conflicts to report. The authors alone are responsible for the content and writing of this paper.

Copyright © American Academy of Addiction Psychiatry.