Replication of an effective opiate addiction pharmacotherapeutic treatment model: Minimal need for modification in a different country

Objective: To determine whether we can replicate, with a similar success, an effective USA model clinic for opiate addiction in another country in spite of major geographical, linguistic and cultural differences. Design: Prospective data on demographic and other factors relating to addiction and treatment were collected, since the establishment of the clinic in July 1993. Setting: New outpatient model methadone maintenance and research clinic for 120-150 patients, affiliated with a major university hospital in Tel Aviv, Israel. Patients: A total of 212 patients with opiate addiction were admitted to clinic and followed from July 1, 1993 until July 1, 1997. Main Outcome Measures: 1. The overall retention and one year retention rate for all patients admitted since July 1993. 2. The prevalence of patients with no evidence of illicit opiate use, after both one and one and a half years in treatment. Results: The overall retention in treatment, irrespective of time in treatment, is 67.9%. The one-year retention rate for all patients admitted since the clinic was opened in July 1993 is 72.5%. After one year in treatment 58.8% (n = 131) of our patients had no further evidence of illicit use of opiates in urine, and after one and a half years of treatment 71.2% (n = 104) had no evidence of illicit opiates use. Conclusion: We have succeeded in replicating a model clinic from the USA in Israel, as shown by the high retention rate and the significant reduction in the use of illicit opiates, in spite of the geographical, linguistic and cultural differences between the countries.