Am J Psychiatry 1994; 151:1031-1037
Copyright © 1994 by American Psychiatric Association
Methadone maintenance outcome as a function of detoxification phobia
JB Milby, AA Hohmann, M Gentile, N Huggins, MK Sims, AT McLellan, G Woody and N Haas
Psychology Service (116-B), VA Medical Center, Birmingham, AL 35233.
OBJECTIVE: Methadone maintenance outcome as a function of detoxification
phobia was examined. METHOD: Opiate addicts (N = 271) in a 1983 random
sample of methadone maintenance patients from three diverse populations
were studied. Subjects from an individually assessed follow-up sample (N =
102) were compared on detoxification phobia. Logistic regression analysis
yielded best predictors of the phobia. RESULTS: Phobic patients were more
likely to be white, female, and abstinent; to have had fewer detoxification
attempts and longer periods on maintenance; to show persistence of the
phobia; to meet diagnostic criteria for depressive or anxiety disorders;
and to have Addiction Severity Index scores above the 75th percentile for
psychological problems. CONCLUSIONS: Detoxification phobia has a complex
relationship to methadone maintenance outcome. It is associated with
greater abstinence for patients in methadone maintenance treatment.
However, for rehabilitated phobic patients it presents a barrier to
successful detoxification and a drug-free adjustment that is often
associated with other psychopathology but could be ameliorated by targeted
assessment and treatment.
