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February 1980

Therapeutic Communities vs Methadone Maintenance: A Prospective Controlled Study of Narcotic Addiction Treatment: Design and One-Year Follow-up

Author Affiliations

From the Veterans Administration Medical Center, Palo Alto (Drs Bale, Van Stone, Kuldau, Engelsing, and Zarcone), the Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford (Drs Bale, Van Stone, Kuldau, Engelsing, and Zarcone), and the Department of Biostatistics, UCLA (Dr Elashoff). Dr Kuldau is now with the Department of Psychiatry, University of Florida, Gainesville.

Arch Gen Psychiatry. 1980;37(2):179-193. doi:10.1001/archpsyc.1980.01780150069008

• This study compares the efficacy of three residential therapeutic communities and an outpatient methadone maintenance program for 585 male veterans addicted to heroin. Subjects were randomly assigned to the treatment modalities. More than 93% of the subjects completed both six- and 12-month questionnaires. In this report, the treatment settings, characteristics of the sample, assignment protocol, and pattern of treatment entry and first-year follow-up results are outlined. The various clinical demands that affected the research protocol, the degree to which the randomization was compromised, and the implications for the analysis of outcome are discussed. One year after admission to the study, subjects who had been in a therapeutic community for longer than seven weeks or in methadone treatment were more likely to be employed or attending school, and less likely to be in jail, using heroin, or to have been convicted of a serious crime, than subjects who received no treatment at all beyond a short detoxification period. Those who spent less than seven weeks in a therapeutic community were doing no better than subjects in the no treatment group.

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