Effects of Compliance on Outcome Independent of Pharmacological Efficacy in the Treatment of Opioid Dependence: A Post Hoc Regression Analysis

In this double-blind controlled study, 143 opioid-dependent male subjects were detoxified and randomly assigned to etrafon (amitriptyline 25 mg and perphenazine 2 tng), methadone, or placebo. Subjects were treated, monitored, and evaluated frequently for 1 year. Reported here are assessments carried out at 3-month intervals after hospital discharge. Treatment effectiveness was defined in terms of improvement of clinical symptoms, employment, and reduction in drug abuse. Data were analyzed on subjects who remained in treatment for at least 3 months (73%)- Data analysis used a random regression model. Overall, type of treatment did not significantly affect outcome. An unexpected but significant effect on outcome seemed due to adherence to drug regimen. Those who adhered to their medication, whether etrafon, methadone, or placebo, improved more than noncompliers on most outcome measures regardless of type of drug treatment.