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Identifying relative strength of methadone versus health and social services in comprehensive substance use disorder treatment using a variance decomposition approach

Bibliographic Data

ID21457084
AuthorsHee-Choon Shin, Jeanne C Marsh (0000-0001-6289-4474, University of Chicago, corresponding author)
Year2022
Volume92
Pages102060
Publication date2022-06-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueEvaluation and Program Planning (JOURNAL)
Journal identifiersISSN: 0149-7189 • E-ISSN: 1873-7870
PublisherElsevier BV (PUBLISHER)
DOI10.1016/j.evalprogplan.2022.102060
PMID35247677
OpenAlexW4213187639
LanguageEN
Citations received1
References cited31

BACKGROUND: The purpose of this study is to identify the relative strengths of association of medication and health and social services in comprehensive substance use disorder (SUD) treatment. OBJECTIVES: The study uses a novel variance decomposition method to assess the relative strength of association of six active ingredients of comprehensive SUD treatment: methadone medication, access services, SUD counseling, matched service ratio, client-provider relationship, and treatment duration. METHODS: The study uses data from the National Treatment Improvement Evaluation Study (1992-1997), a dataset with an unusual number of services and service strategies measured. The data include 3012 clients from 45 SUD treatment programs. Linear mixed models are used to assess the relation of service variables to the outcome of posttreatment substance use. Variance decomposition methods are used to assess the relative importance of the ingredients in the treatment model. RESULTS: Along with a random intercept and background variables, receipt of methadone accounted for the greatest relative strength of association at 35.4%, compared with 23.8% for treatment duration, 15.4% for client-provider relationship, and 11.2% for matched service ratio. Access and SUD counseling accounted for modest strengths of association at 1% and 3% each. CONCLUSION: Findings indicate somewhat greater strength of association of methadone compared with other services and service strategies and overall, reinforce the importance of both medication and services and service strategies in the design and development of effective models of service delivery. SIGNIFICANCE: This study, among the first to evaluate the relative importance of specific services and service strategies of comprehensive SUD treatment, provides insights relevant to the development of effective models of service delivery

Business · Methadone · Methadone maintenance · Psychiatry · Receipt · Relative risk · Service (business) · Substance abuse · Clinical Psychology · HIV, Drug Use, Sexual Risk · Marketing · Medicine · Opioid Use Disorder Treatment · Psychology · Substance Abuse Treatment and Outcomes

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Unique citing works1
Citations per year0.33
Citation span2023 - 2023 (1)
Citation velocityhistorical
Highly citedNo
Citation typesNeutral: 1

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