Methadone maintenance treatment: harm reduction or rehabilitation?

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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Aproximacions a la perspectiva de la persona en tractament de manteniment amb metadona: Reflexions a propòsit de 10 anys de recerca / Approaches to the perspective of the individual receiving methadone maintenance treatment: Reflections on 10 years of research

Aloma: Revista de Psicologia, Ciències de l'Educació i de l'Esport ◽

10.51698/aloma.2017.35.2.39-50 ◽

2017 ◽

Vol 35 (2) ◽

pp. 39-50

Author(s):

Joan Trujols Albet ◽

Joan Guàrdia-Olmos ◽

Ioseba Iraugui ◽

José Pérez de los Cobos

Keyword(s):

Harm Reduction ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Heroin Dependence ◽

Psychopharmacological Treatment ◽

Harm Reduction Intervention ◽

The Individual

Resum. Els tractaments de manteniment amb metadona (TMM) són un autèntic tractament psicofarmacològic de la dependència d’heroïna i, a la vegada, un element indispensable de les polítiques i les intervencions de reducció de danys. L’efectivitat dels TMM ha estat avaluada, gairebé de manera exclusiva, mitjançant la utilització d’indicadors anomenats durs. Intentant anar més enllà d’aquest enfocament tradicional, hem portat a terme, durant els darrers 10 anys, diversos estudis emprírics i assaigs teòrics que s’emmarquen dins d’un objectiu global de generar coneixement al voltant de –i amb– la perspectiva de la persona en TMM. En aquest article, resumim de manera selectiva les troballes més rellevants d’aquesta línia de recerca per discutir després algunes de les seves principals implicacions. Finalment, abordem alguns dels reptes –i suggerim alguns dels canvis necessaris– per a una avaluació dels TMM realment centrada en el pacient.Summary. Methadone maintenance treatment (MMT) is both a specific psychopharmacological treatment of heroin dependence and a core harm-reduction intervention. Over the last 10 years we have been working to break the mould of the traditional focus on the so-called hard indicators of MMT effectiveness, pursuing instead a line of research that makes room for the consideration of the perspectives of methadone-maintained patients, resulting in several empirical and theoretical papers. Firstly, this commentary briefly and selectively summarizes some key findings from five of these papers. It then discusses the main implications of these findings. Finally, it addresses some of the challenges involved in conducting a genuinely patient-centred evaluation of MMT, along with some of the changes that would be required to accomplish this.

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“It’s like ‘liquid handcuffs”: The effects of take-home dosing policies on Methadone Maintenance Treatment (MMT) patients’ lives

Harm Reduction Journal ◽

10.1186/s12954-021-00535-y ◽

2021 ◽

Vol 18 (1) ◽

Author(s):

David Frank ◽

Pedro Mateu-Gelabert ◽

David C. Perlman ◽

Suzan M. Walters ◽

Laura Curran ◽

...

Keyword(s):

Harm Reduction ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Qualitative Interviews ◽

Daily Basis ◽

Treatment Needs ◽

Treatment Providers ◽

Number Of Patients ◽

Daily Attendance

Abstract Background Methadone Maintenance Treatment (MMT) is widely recognized as one of the most effective ways of reducing risk of overdose, arrest, and transmission of blood-borne viruses like HIV and HCV among people that use opioids. Yet, MMT’s use of restrictive take-home dose policies that force most patients to attend their clinic on a daily, or near-daily, basis may be unpopular with many patients and lead to low rates of treatment uptake and retention. In response, this article examines how clinics’ take-home dosing policies have affected patients’ experiences of treatment and lives in general. Methods This article is based on semi-structured, qualitative interviews with a variety of stakeholders in MMT. Interviews explored: reasons for engaging with, or not engaging with MMT; how MMT is conceptualized by patients and treatment providers (e.g., as harm reduction or route to abstinence and/or recovery); experiences with MMT; perception of barriers to MMT (e.g., organizational/regulatory, social) and how MMT might be improved to support peoples’ substance use treatment needs and goals. Results Nearly all of the patients with past or present MMT use were highly critical of the limited access to take-home doses and consequent need for daily or near daily clinic attendance. Participants described how the use of restrictive take-home dose policies negatively impacted their ability to meet day-to-day responsibilities and also cited the need for daily attendance as a reason for quitting or avoiding OAT. Responses also demonstrate how such policies contribute to an environment of cruelty and stigma within many clinics that exposes this already-stigmatized population to additional trauma. Conclusions Take-home dose policies in MMT are not working for a substantial number of patients and are reasonably seen by participants as degrading and dehumanizing. Revision of MMT regulations and policies regarding take home doses are essential to improve patient satisfaction and the quality and effectiveness of MMT as a key evidence-based treatment and harm reduction strategy.

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