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Abstract
This study examined factors associated with retention in an opioid treatment program and explored whether continued stimulant use affected retention. Clinical data from 153 patients enrolled in a trial comparing six months of buprenorphine/naltrexone versus methadone were analyzed. A secondary analysis evaluated patient characteristics and program factors, and a Markov chain analysis assessed differences in stimulant use by treatment type. Patients on methadone, those who began treatment later in the study, attended weekly group sessions, had longer periods of abstinence in the prior year, or were not intravenous drug users showed better retention. Buprenorphine did not reduce stimulant use more effectively than methadone. Findings suggest that methadone combined with counseling supports greater treatment retention, which may lead to improved outcomes, while neither medication showed clear advantages in reducing stimulant use.