Factors associated with methadone maintenance therapy use among a cohort of polysubstance using injection drug users in Vancouver

2005 ◽  
Vol 80 (3) ◽  
pp. 329-335 ◽  
Author(s):  
Thomas Kerr ◽  
David Marsh ◽  
Kathy Li ◽  
Julio Montaner ◽  
Evan Wood
Keyword(s):  
Maintenance Therapy ◽  
Injection Drug Users ◽  
Drug Users ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Injection Drug ◽  
Factors Associated

Barriers and facilitators to methadone maintenance therapy use among illicit opiate injection drug users in Vancouver

2006 ◽  
Vol 2 (1) ◽  
pp. 35 ◽  
Author(s):  
Cody Callon, BSc ◽  
Evan Wood, PhD ◽  
David Marsh, MD ◽  
Kathy Li, PhD ◽  
Julio Montaner, MD ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Injection Drug Users ◽  
Drug Users ◽  
Addiction Treatment ◽  
User Study ◽  
Crack Cocaine ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Injection Drug ◽  
Downtown Eastside

Methadone maintenance therapy (MMT) has been increasingly implemented as the treatment of choice for opiate-addicted individuals and has been associated with reduced harm related to opiate addiction. Barriers to MMT uptake still exist, however, and many opiate-addicted individuals do not access this form of treatment.We examined barriers to and facilitators of MMT access among opiate users enrolled in a prospective cohort study of injection drug users (IDUs). We identified individuals who had initiated MMT during follow-up interviews and used generalized estimating equations to identify sociodemographic and drug-related variables associated with MMT access.Of the 1,587 participants recruited into the Vancouver Injection Drug User Study, 1,463 individuals were eligible for the present analysis. Factors negatively associated with MMT use included male gender (odds ratio [OR] = 0.41; 95 percent confidence interval [CI], 0.32 to 0.52), Aboriginal ethnicity (OR = 0.37; 95 percent CI, 0.29 to 0.48), recent incarceration (OR = 0.82; 95 percent CI, 0.72 to 0.93), Downtown Eastside residence (OR = 0.86; 95 percent CI, 0.75 to 0.97), sex-trade involvement (OR = 0.80; 95 percent CI, 0.67 to 0.95), syringe lending (OR = 0.76; 95 percent CI, 0.66 to 0.89), denied addiction treatment (OR = 0.81; 95 percent CI, 0.68 to 0.96), heroin injection (OR = 0.51; 95 percent CI, 0.44 to 0.59), nonfatal overdose (OR = 0.59; 95 percent CI, 0.51 to 0.68), and injecting in public (OR = 0.75; 95 percent CI, 0.63 to 0.89). Older age (OR = 1.03; 95 percent CI, 1.01 to 1.04), human immunodeficiency virus (HIV) positivity (OR = 1.89; 95 percent CI, 1.52 to 2.23), and crack cocaine smoking (OR = 1.41; 95 percent CI, 1.22 to 1.62) were positively associated with MMT use.Our study identified a large number of barriers to and facilitators of MMT use among IDUs. While some populations such as HIV-positive individuals are frequently accessing MMT, identified barriers among men and Aboriginal IDUs are of great concern. These findings indicate the need for additional interventions aimed at maximizing coverage of MMT and other treatments for opiateaddicted individuals.

scholarly journals Methadone maintenance therapy promotes initiation of antiretroviral therapy among injection drug users

Addiction ◽  
2010 ◽  
Vol 105 (5) ◽  
pp. 907-913 ◽  
Author(s):  
Sasha Uhlmann ◽  
M.-J. Milloy ◽  
Thomas Kerr ◽  
Ruth Zhang ◽  
Silvia Guillemi ◽  
...  
Keyword(s):  
Antiretroviral Therapy ◽  
Maintenance Therapy ◽  
Injection Drug Users ◽  
Drug Users ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Injection Drug

scholarly journals Factors associated with willingness to participate in a heroin prescription program among injection drug users

2005 ◽  
Vol 1 (4) ◽  
pp. 201 ◽  
Author(s):  
Cari L. Miller, MSc ◽  
Steffanie A. Strathdee, PhD ◽  
Thomas Kerr, PhD ◽  
Will Small, MA ◽  
Kathy Li, MSc ◽  
...  
Keyword(s):  
Injection Drug Users ◽  
Drug Users ◽  
Crack Cocaine ◽  
Methadone Maintenance ◽  
Injection Drug ◽  
Willingness To Participate ◽  
High Risk Behaviors ◽  
Once Daily ◽  
Factors Associated ◽  
Heroin Prescription

Randomized controlled trials of prescription heroin have shown success in reducing drug-related harm among chronic opiate injection drug users (IDUs) in several European nations. We sought to explore willingness to participate in a heroin trial among a well-characterized North American cohort of IDUs, and therefore performed analyses of factors associated with willingness to participate in a prescription heroin trial among IDUs enrolled in the Vancouver Injecting Drug Users Study (VIDUS). Of 410 current heroin injectors followed between May and November 2002, injecting heroin frequently (more than once daily) [odds ratio (OR) 1.33; 95 percent confidence interval (CI) 1.06 to 1.69] and being enrolled in methadone maintenance therapy (MMT; OR 1.33, 95 percent CI 1.06 to 1.69) were associated with willingness to participate in a trial. In subanalyses, statistical associations with willingness to participate in a trial among current MMT users were frequent injection of heroin (OR 2.12, CI 1.16 to 3.88) and speedballs (OR 2.57, CI 1.02 to 6.48), frequent crack cocaine use (OR 1.84, CI 1.11 to 3.06), lending of syringes (OR 3.22, CI 1.08 to 9.65), and requiring help to inject (OR 1.83, CI 1.01 to 3.33). Among IDUs, willingness to enroll in a heroin prescription program was associated with highintensity heroin injection and high-risk behaviors and was particularly prevalent among individuals who have been unable to significantly reduce their injection drug use on MMT alone. These findings indicate that a clinical trial of prescribed heroin should be able to enroll an appropriate sample of drug users and properly assess the treatment potential of prescribed opiate pharmacotherapy.

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