Contracting for treatment termination to reduce illicit drug use among methadone maintenance treatment failures.

Objective. To report the one-year retention rate and the prevalence of illicit opioid use and cocaine use in the Low-Threshold/High-Tolerance (LTHT) methadone maintenance treatment (MMT) clinic located in Saint John, New Brunswick, Canada.Methods. A description of the LTHT MMT clinic is provided. The one-year retention rate was determined by collecting data on patients who enrolled in the LTHT MMT clinic between August 04, 2009 and August 04, 2010. The prevalence of illicit drug use was determined using a randomly selected retrospective cohort of 84 participants. For each participant the results of six consecutive urine tests for the most recent three months were compared to the results of the first six consecutive urine tests after program entry.Results. The one-year retention rate was 95%, 67% of the cohort achieved abstinence from illicit opioids and an additional 13% abstained from cocaine use.Conclusion. The novel feature of the LTHT MMT clinic is that patients are not denied methadone because of lack of ancillary services. Traditional comprehensive MMT programs invest the majority of financial resources in ancillary services that support the biopsychosocial model, whereas the LTHT approach utilizes a medical model and directs resources at medical management.

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The Effects of Methadone Maintenance with Opioid Takers: A Review and Some Findings from One British City

The British Journal of Psychiatry ◽

10.1192/bjp.132.5.473 ◽

1978 ◽

Vol 132 (5) ◽

pp. 473-481 ◽

Cited By ~ 11

Author(s):

Roger Paxton ◽

Patrick Mullin ◽

Jack Beattie

Keyword(s):

Drug Use ◽

Social Functioning ◽

Social Adjustment ◽

Illicit Drug ◽

Methadone Maintenance ◽

Criminal Activity ◽

Illicit Drug Use ◽

Work Status ◽

Methadone Group ◽

Firm Evidence

SummaryVarious benefits claimed for methadone maintenance in the treatment of opioid drug takers are reviewed. It is said to stop illicit drug use, maintain treatment contact, reduce morbidity, mortality and crime, and improve social adjustment. Little firm evidence is found to support these claims. Results are reported comparing 26 drug takers on methadone prescriptions with 16 illicit opioid takers. The measures used are Stimson's (1972) ‘Patterns of Behaviour’ questionnaire, and direct behavioural measures of social functioning. The groups are found not to differ in terms of treatment contact, work status and involvement with other drug takers. There is some evidence that the methadone group is involved in less criminal activity. However, no association is found between amounts of drugs prescribed and numbers of local pharmacy thefts. It is concluded that the benefits of methadone maintenance have been exaggerated.

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Reduction of the Frequency of Drug Use of Veterans Enrolled in an Outpatient Methadone Maintenance Treatment Program

International Journal of the Addictions ◽

10.3109/10826088109039184 ◽

1981 ◽

Vol 16 (7) ◽

pp. 1277-1280

Author(s):

Mark Eisenberg ◽

Cecil D. Isaacs ◽

Andre Bourque

Keyword(s):

Drug Use ◽

Treatment Program ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Methadone Maintenance Treatment Program

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Predictors of Positive Outcomes for Out-of-Treatment Opiate Injectors Recruited into Methadone Maintenance through Street Outreach

Journal of Drug Issues ◽

10.1177/002204260203200316 ◽

2002 ◽

Vol 32 (3) ◽

pp. 999-1016 ◽

Cited By ~ 17

Author(s):

Karen Fortuin Corsi ◽

Carol F. Kwiatkowski ◽

Robert E. Booth

Keyword(s):

Drug Use ◽

Behavior Change ◽

Hiv Risk ◽

Methadone Maintenance Treatment ◽

Injection Drug Users ◽

Drug Users ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Positive Outcomes

This study was conducted to assess behavior change in the areas of drug use, productivity, criminal activity, and HIV risk among street-recruited injection drug users who entered methadone maintenance treatment. In addition, the study examined a number of variables that could account for these changes, including demographics, intervention effects, and treatment-related measures. A total of 168 participants were interviewed at baseline, received outreach interventions, entered methadone maintenance treatment, and were reinterviewed 5–9 months later. Significant (p<.001) improvements were seen in the areas of drug use, productivity, criminality, and HIV risk behaviors. The only variables significantly associated with behavior change were related to drug treatment. In particular, being in treatment at the time of the follow-up assessment had the strongest relationship to positive outcomes, including length of treatment. Having no prior treatment experience was associated with fewer injections at follow-up. These findings emphasize the importance of retaining clients, given the likelihood that positive change is likely to be evidenced while they remain in treatment

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Rehab, respite and recovery: the experiences of methadone users in a modified therapeutic community (MTC) in Scotland

Therapeutic Communities The International Journal of Therapeutic Communities ◽

10.1108/tc-08-2014-0028 ◽

2015 ◽

Vol 36 (2) ◽

pp. 124-136

Author(s):

Iain McPhee ◽

Denice Fenton

Keyword(s):

Drug Use ◽

Illicit Drug ◽

Service Providers ◽

Therapeutic Community ◽

Methadone Maintenance ◽

Illicit Drug Use ◽

Cultural Norms ◽

Service Users ◽

Content Type ◽

Rich Data

Purpose – There is limited research documenting recovery experiences of residential service users. The purpose of this paper is to explore the perceptions service users on methadone have about recovery. In depth, semi structured 1-1 interviews with seven poly drug using homeless males between the ages of 37 and 46 and analysed using NVivo software. Results are presented thematically. Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to former addict identities. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms that equate recovery with abstinence. Tensions were revealed in true motivations for active rather than passive participation in adopting group work norms. Design/methodology/approach – A qualitative design utilises small numbers of participants to gather rich data. In depth, semi structured 1-1 interviews conducted with seven poly drug using homeless males who have completed between ten and 15 weeks of a minimum 26-week residential treatment programme. Participants were aged 37-46. Results were analysed thematically using NVivo software. Findings – Participants conform to “recovery” norms allowing stigma and shame of illicit drug use to be attributed to a former stigmatised addict identity. Participants on methadone maintenance report inner conflict arising from changing societal and cultural norms regards recovery and abstinence. A significant process of recovery involved adopting the norms of 12-step groups and TC therapy to gain enough trust to leave the therapeutic community (TC) unsupervised. This created tension regards motivation, were these individuals in recovery, or merely “faking it”? Research limitations/implications – A female perspective may have provided a more balanced discussion and yielded greater depth in results. Only one service was studied and the findings may be specific to that cohort. The duration of stay at the service of ten to 15 weeks is a relatively short time and excluded participants resident for six months or more. Longer term residents may have been more reflective and informative. Practical implications – Encourage active options and increased debate on the variety of treatment options available to long term homeless opiate users who have failed to comply with previous treatments. While this is a small modest study, the rich data yields practical advice for policy makers and service providers. Social implications – This research study adds to an informed perspective by encouraging debate on methadone as a challenge to definitions of recovery that infer abstinence as a key definition of success. Originality/value – There is a paucity of research documenting a Scottish TC service user perspective using qualitative methods on experiences of addiction, treatment and recovery.

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Faktor-Faktor yang Mempengaruhi Pengguna Napza Suntik dalam Tindakan Pemanfaatan Layanan Program Terapi Rumatan Methadon (PTRM) di Kota Cirebon

JURNAL PROMOSI KESEHATAN INDONESIA ◽

10.14710/jpki.11.2.18-31 ◽

2016 ◽

Vol 11 (2) ◽

pp. 18

Author(s):

Dessy Aryanti ◽

Bagoes Widjanarko ◽

Kusyogo Cahyo

Keyword(s):

Drug Use ◽

Harm Reduction ◽

Treatment Program ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Health Workers ◽

Methadone Maintenance ◽

Family Attitudes ◽

Methadone Maintenance Treatment Program ◽

Hiv Aids

ABSTRACTAccording to the risk factors as a result of injecting drug use (IDU) were second highest, after the heterosexual and homo-bisexual. In IDUs face two risks for contracting HIV / AIDS, from the use of unsterilized needles and performed together or alternately with other IDUs and also through sexual intercourse, especially that done with more than one partner without using a condom. Methadone maintenance treatment program (PTRM) is included in the Harm Reduction program – This is a program of harm reduction drug use in preventing transmission of HIV / AIDS. This research is quantitative with correlational design, sampling using the technique across sectional the total population 50 person IDUs of injecting drug users in the city of Cirebon -use structured questionnaires technique. From the 50 IDUs who were respondents in this research note that 68% did not use PTRM services. It is because most IDUs still can not stop using injection drugs and have not been willing to switch to PTRM. Results of univariate analysis to determine the level of knowledge of IDUs about PTRM 88% have a good category, the attitude of the respondents 80% have category support PTRM, family attitudes 50% have category support PTRM, attitudes of peers 72% have a category does not support the utilizations PTRM, attitude of health workers 66% category does not support PTRM, and the availability of facilities and health facilities 52% support in PTRM services. For the bivariate analysis showed that the attitude of IDUs to program substitution therapy methadone-related measures the utilization of PTRM, whereas knowledge factors, family attitudes, attitudes of peers, attitude of health workers, and the availability of facilities. Then knowledge of IDUs about PTRM shows no relationship with the actions the utilization of PTRM , And based on multivariate analysis known that the action the utilization of PTRM is influenced by the family attitudes were supportive of the utilizations of Methadone maintenance treatment program (PTRM).Keywords: drug, injection, PTRM, HIV/AIDS

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