Methadone treatment in medical private practice: outcome according to the number of courses followed.

In the Swiss Canton of Vaud, methadone treatment is mostly provided by the private medical practitioners. 562 opioid dependent persons followed at least one course of treatment between 1976 and 1986; at that time, 209 of them had completed a first course, 118 a second one and 31 a third one. Evolution of the persons was observed from the end of their last course to the end of the study. Outcome was evaluated according to the rank of the last course. Whatever its rank, each course resulted in about 17% of stable abstainers and 6% of chronic opioid-dependent persons. In contrast, the risks to start a new course, to be imprisoned and to enter into a therapeutic community showed a clear gradient with the rank of the course: they were about 38%, 27% and 10% respectively one year after a first or a second course, and rose to 43%, 38% and 28% one year after a third course.