Women and men in methadone treatment: Do *attitudes predict outcome?

Abstract

The purpose of this study was to compare the attitudes of men and women entering methadone maintenance treatment and to determine whether attitudinal differences are related to premature termination. The attitudes examined were opinions about the treatment modality; self efficacy to prevent HIV transmission; and readiness for change in drug-using behavior.;The present study adds to the relatively new and growing literature on gender-related differences, which has identified characteristics and needs that are unique to women. Like many other such studies, this one is grounded in feminist theory, specifically in regard to the development of autonomy. Due to gender differences in socialization, women are more conflicted than men about expressing this fundamental human yearning. The presence or absence of conflict in this regard shapes the attitudes at play as individuals face crises and choice points, including the choice to enter treatment. This study looked for gender patterns in three of these attitudes.;The sample of 338 respondents was 25% female. All were new enrollees in methadone treatment, recruited and interviewed in 1997 and 1998, immediately after their intake and assignment to a treatment site. Measures included the following scales: Opinions About Methadone (Brown, 1975); HIV Self Efficacy (Smith et al., 1996), and Drug Use Stage of Change (Booth et al., 1998). The present Study is a secondary analysis.;The following hypotheses were tested: (1) Men hold more negative opinions about methadone treatment than women do. (2) Men express greater HIV self efficacy than women do. (3) Men's readiness for change is lower than women's. (4) Those with negative attitudes are likeliest to terminate prematurely. (5) Sex and attitude simultaneously predict dropout. (6) Readiness for change contributes most to likelihood of premature termination.;The significant findings did not support the hypotheses. Men and women differed significantly in HIV self efficacy, but in the opposite direction from that predicted by this hypothesis. Sex and attitude did not simultaneously predict dropout. Although the study largely failed to identify gender differences, it did demonstrate that the Opinions About Methadone scale predicts premature termination. The scale should, therefore, be useful to counselors conducting assessments.