Treatment Fees and Retention on Methadone Maintenance

Several reports have suggested that required treatment fees impair retention on methadone maintenance. In a controlled study, 152 illicit opioid users admitted to methadone maintenance were randomly assigned to fee or nofee status. The fee subjects were required to pay a fee of $2.50per day and the no-fee subjects were required to pay nothing. Elimination of fees significantly increased retention. Only 34% of the fee subjects but 54% of the no-fee subjects were retained for one year. Of those retained for one year, the fee subjects and the no-fee subjects showed only small and nonsignificant differences on urine test results and measures of social performance. Interviews per month with caseworker were inversely related to retention. Increased interviews and decreased retention may both have reflected treatment problems of subjects.