Protective Factor Predictors of Abstinence and Retention in Patients Receiving Methadone Treatment for Opioid Use Disorder

Methadone maintenance treatment (MMT) is an evidence-based intervention for opioid use disorder (OUD). Despite its effectiveness, drug use during treatment and dropout are common. Most MMT outcome studies have ignored or examined few protective factors. This study examines protective factor predictors of two primary MMT outcomes, drug abstinence and treatment retention. Patients ( N = 118) initiating MMT completed baseline surveys. Urine drug screen and retention data were extracted from medical records. We assessed protective factors organized across five domains (treatment history, opioid-related, intrapersonal, relational, and socioeconomic/community). Bivariate and multivariable linear regression analyses and a Cox proportional-hazards model were conducted. Opioid-related factors (change readiness, use-related consequences) best predicted outcomes. Some treatment history (prior, earlier engagement) and socioeconomic/community (past 30-day income) factors had a protective influence, whereas intrapersonal factors (gratitude, searching for meaning-in-life) produced mixed findings. One relational factor (emotional support) approached significance. Our findings highlight innovative approaches that may help improve MMT outcomes.