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Effectiveness of drug and alcohol counselling during methadone treatment: content, frequency, and duration of counselling and association with substance use outcomes


Professor Michael Gossop, National Addiction Centre, The Maudsley/Institute of Psychiatry, Kings College London, London, UK. E-mail:


Aims  The study investigates the relationship between the type and severity of drug and alcohol use problems, and the provision of drug- and alcohol-counselling in methadone programmes. The study also specifically investigates the relationship between content, frequency and duration of counselling provided during the first month of treatment, and heroin, cocaine, and alcohol use outcomes at 6 months. 

Design, setting and participants  The sample comprised 276 patients receiving outpatient methadone treatment who were followed-up 6 months after treatment entry.

Measurements  Data on client characteristics, drug and alcohol problems and on counselling received were collected by structured face-to-face interviews.

Findings  Drug-focused counselling was associated with less frequent heroin and cocaine use at follow-up, but was not related to pre-treatment drug use. Alcohol-focused counselling was provided for those with higher levels of drinking at admission but was not significantly associated with drinking outcome at 6 months.

Conclusions  Results indicate that there are complex interactions between presenting substance use problems, provision of counselling and treatment outcomes. These interactions differ by substance type.