Treating opioid use under California's Proposition 36: differential outcomes by treatment modality.

In California, Proposition 36 (Prop. 36) has led to positive outcomes for a significant proportion of participants-increases in drug treatment completion, reduced drug use and recidivism, and increased employment. However, there are notable differences in outcomes among Prop. 36 subgroups, with some of the poorest outcomes observed among opioid users. This may be because very few Prop. 36 opioid users were placed in narcotic treatment programs (NTPs). Prop. 36 opioid users who were placed in NTPs using methadone had the greatest reductions in opioid use from treatment intake to discharge, as compared to Prop. 36 opioid users who received outpatient drug-free or residential treatment. As such, NTPs should be considered to be a highly efficacious and viable treatment option for Prop. 36 opioid users. Thus, to improve treatment outcomes among Prop. 36 opioid users, it is essential that the provision and utilization of NTPs be enhanced.