Abstinence following detoxification and methadone maintenance treatment.

During an 11 year overview of methadone treatment, 161 (72 per cent) of 225 patients who completed detoxification were followed up to eight years. Fifty-one (22.6 per cent) of those were classified as stable and narcotic free 2.9 years after detoxification. Of 89 self-selected patients who had undergone a planned, supported, "therapeutic" detoxification, 37 (42 per cent) were classified narcotic-free; whereas many fewer were so judged after other methods of detoxification. Relapse to nonprescribed opioid use, detected in 34 (38.7 per cent) of those traced, was inversely related to time since detoxification. Relapse potential was very low after three years of apparent continuous narcotic-free existence; three years should be a minimal time for successful detoxification. Some subjects had several cycles of methadone treatment and detoxification. Most patients with combined alcohol-methadone dependencies did poorly, whether or not detoxification from opioids was undertaken. Since the frequency of enduring narcotic-free state was only 9.7 per cent of 522 patients in the treatment sample, detoxification should not be a realistic goal for all patients who enter treatment.