Effectiveness of Rapid Intake into Methadone Treatment: A Natural Experiment in Israel

The effect of intake procedures on treatment entry and retention was examined in a natural experiment, in which a methadone maintenance clinic in Israel admitted 127 clients by employing a rapid intake procedure (maximum of 3 days before the initiation of treatment was offered). Using information gathered from patient files, these clients were retrospectively compared to a control group (n = 121) who underwent the clinic's regular intake procedure (between 3 weeks and 3 months). Outcome measures included entry into treatment and subsequent retention in treatment (at 3, 6 and 12 months). Results show that 81% of clients from the rapid intake group entered treatment compared to only 57% from the regular intake group. Treatment retention was similar for both groups. In addition, Jewish clients were more likely to enter treatment via the rapid intake procedure than clients from other religions, and women were retained in treatment longer than men, regardless of the type of intake procedure. Results of this single-site study lend support to the effectiveness of rapid intake procedures as a way to engage clients in treatment and carry significant implications for improving access into treatment.

Drinking and blood pressure during sodium depletion or ANG II infusion in chronic cholestatic rats

After a chronic ligation of the common bile duct (BDL), Long-Evans rats are hypotensive and have elevated saline intake during both sodium-depleted and nondepleted conditions. We tested whether BDL rats have exaggerated hypotension during sodium depletion or an elevated dipsogenic response to angiotensin II (ANG II) that might help to explain the saline intake. After 4 wk of BDL, rats were hypotensive at baseline and developed exaggerated hypotension during acute furosemide-induced diuresis. Without saline to drink, BDL rats increased water intake during depletion equal to sham-ligated rats. However, with saline solution available at 22 h after sodium depletion, the BDL rats drank more water and saline than did sham-ligated rats. This rapid intake temporarily increased their mean arterial pressure to equal that of sham-ligated rats. Intravenous infusion of ANG II induced equal drinking responses despite reduced pressor responses in the BDL rats relative to sham-ligated rats during both ad libitum and sodium-depleted conditions. Thus BDL rats have exaggerated hypotension during diuresis, and their hypotension is corrected by drinking an exaggerated volume of saline, but they do not have an increased drinking response to ANG II.