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

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.

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

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

scholarly journals 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

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.

scholarly journals Opioid Dependence And Methadone Maintenance Treatment (MMT) Programme In Nepal In Three Different Decades: An Exploratory/Comparative Study

2020 ◽  
Vol 9 (2) ◽  
pp. 3-11
Author(s):  
DM Shrestha ◽  
TK Aich ◽  
K Gautam ◽  
D Bajracharya
Keyword(s):  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Family Members ◽  
Study Data ◽  
Published Data ◽  
Number Of Patients ◽  
Illicit Drug Abuse ◽  
New Millennium

Introduction: First Methadone Maintenance Programme (MMTP) in Nepal was started in the year 1994. This study was done to study and explore/compare findings of the present study with that of studies published in Nepal in the new millennium. Material and Method: Study was conducted at the Mental Hospital, Lalitpur, Kathmandu, Nepal from 1994 to 2002. Data was collected for the initial 5 years from 1994 to 1998. These patients were followed up for the next five years till 2002. Data thus obtained are presented in a tabulated form, in terms of frequencies and percentages. Results: A total of 204 patients were put on Methadone Maintenance Treatment Programme (MMTP) during the scheduled period. One-hundred-and-twenty-two (60%) of them were abusing buprenorphine. Severity of buprenorphine abuse was between 1-6 ampoules (2 ml per ampoule) per day. Approximately 40% (81) of them were sharing the injecting equipment. Seventy-seven (38%) of them had been in police custody in the past, for various reasons like theft, cheating, possessing, trafficking, violence and other antisocial behaviours. Forty-five percent (92) clients were retained at the end of 5 years. Sixty-nine family members (spouses, mothers, brothers) from these 92 regular methadone clients were interviewed. Eighty-six percent (79) of the interviewed family members reported significant improvement in clients’ health. Eighty-one percent (75) of the family members reported significant improvement among the methadone users’ family in financial responsibilities and interest in work. Overall, MMTP was found to have reduced the amount of illicit drug abuse significantly in these patients. These results are compared with the data of the subsequent published data on MMTP from Nepal in the new millennium. Conclusion: Though the present study data may appear to be of historical value, we are presenting these data, in the light of the findings of the newer studies published of late from Nepal. Till date, our study remained the largest MMT Programme in Nepal, in terms of number of patients studied, number of years of study and number of years of follow up of these patients.

scholarly journals Methadone maintenance treatment in Spain: the success of a harm reduction approach

2013 ◽  
Vol 91 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Marta Torrens ◽  
Francina Fonseca ◽  
Claudio Castillo ◽  
Antonia Domingo-Salvany
Keyword(s):  
Harm Reduction ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Reduction Approach
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