Changes in the Number of Methadone Maintenance Slots as Measures of “Fighting Back” Program Effectiveness

Abstract

This study examined trends in the number of available methadone maintenance treatment (MMT) slots to evaluate a community-based drug prevention program. In the 1990s, the “Fighting Back” (FB) initiative sought to reduce substance use and harm through community-based coalitions in 14 sites across the U.S. Nine state agencies provided MMT data for 28 FB and control communities for a 10-year period prior to and during the program. Opioid use data from a general population survey conducted in the same communities by the national evaluation team were also examined. Counter to expectation, implementation of the FB program was associated with significantly less expansion of MMT slots when compared to control communities. This trend was not attributable to opioid use in those communities, which did not change during the same period. The implication of the findings as well as the historical context of methadone maintenance treatment since the 1990s is also discussed.