scholarly journals National survey of methadone prescribing for maintenance treatment: ‘opiophobia’ among substance misuse services?

2005 ◽  
Vol 29 (12) ◽  
pp. 459-461 ◽  
Author(s):  
Renju Joseph ◽  
Hamdy F. Foselpy
Keyword(s):  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Substance Misuse ◽  
Methadone Maintenance ◽  
Psychosocial Interventions ◽  
Postal Questionnaire ◽  
Community Based ◽  
Department Of Health ◽  
Daily Dose ◽  
The Mean

Aims and MethodThe aims of this study were to describe the characteristics of substance misuse services prescribing methadone for maintenance treatment of opioid dependence and to determine the average daily doses of methadone prescribed across England. A postal questionnaire survey of all substance misuse treatment centres in England was carried out.ResultsA total of 298 treatment centres were identified and contacted, 212 of which responded to the survey (response rate of 71%). Of these, 157 were prescribing methadone for maintenance treatment; the majority (71%) were community-based and 125 centres had doctors attached. The most common formulation of methadone prescription was oral methadone mixture (152 centres, 97%). The mean daily dose of methadone prescribed was 47 mg. Surprisingly, 37 (24%) of the respondents felt that methadone maintenance treatment should be time-limited and 21 teams (13%) stated that patients should receive only drug substitution and no psychosocial interventions.Clinical ImplicationsThere is currently a move among substance misuse services towards community-based treatment. In our survey, the mean daily dose of methadone prescribed was less than the dosage recommended by the Department of Health. This suggests that specialist addiction services are continuing to underprescribe heroin substitutes. The inadequate understanding of some of the respondents of the basic principles of methadone maintenance treatment also raises concerns, and highlights the need for further training and education.

scholarly journals Factors Associated with Compliance among Methadone Maintenance Treatment Transfers: Evidence from Audit Records at Clinics in Guangdong, China

2019 ◽  
Vol 16 (11) ◽  
pp. 2023
Author(s):  
Cheng Gong ◽  
Xia Zou ◽  
Wen Chen ◽  
Yin Liu ◽  
Qian Lu ◽  
...  
Keyword(s):  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Transfer System ◽  
Regression Analyses ◽  
Web Based ◽  
Transfer Rates ◽  
Factors Associated ◽  
Daily Dose ◽  
Transfer Services

Methadone maintenance treatment (MMT) requires patients to intake their daily dose in person at their clinic. Therefore, transfer services are vital for patients who need temporary leave from their primary MMT clinic. However, studies have shown that transfer patients might delay return after temporary leave, leading to missed doses and putting them at risk of increased harm. In this study, we aimed to explore the transfer rates and factors associated with MMT patients who delayed return during a transfer period. In this retrospective analysis, we used audit records from the web-based management system from six MMT clinics in Guangdong, China. Multilevel logistic regression and multilevel Poisson regression analyses were used to examine the factors associated with patients who delayed return to their primary MMT clinic. A total of 459 people used the transfer system 2940 times between January 2006 and December 2016. Of those, patients delayed return to their primary MMT clinic 1199 times (40.78%). Patients who transferred regularly had poor compliance rates with MMT treatment. Those who once dropped out from and then re-enrolled in MMT were more likely to delay return. Most patients (82.71%) who used the transfer service for “work” were more likely to prolong their delay length. The findings highlight that a more flexible transfer system would minimize inconvenience to the patients.

Methadone as an analgesic for patients with chronic pain in methadone maintenance treatment programs (MMTPs)

2018 ◽  
Vol 5 (2) ◽  
pp. 107 ◽  
Author(s):  
Craig D. Blinderman, MD, MA ◽  
Ryuichi Sekine, MD ◽  
Baohui Zhang, MS ◽  
Matthew Nillson, MS ◽  
Lauren Shaiova, MD
Keyword(s):  
Chronic Pain ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Pain Clinic ◽  
Treatment Programs ◽  
Methadone Dose ◽  
Pain Syndromes ◽  
The Mean ◽  
Chronic Pain Syndromes

Background: Limited case reports have suggested a role for methadone as an analgesic for chronic pain in patients maintained on methadone for treatment of opiate addiction. Patients with HIV are disproportionately represented in this population and often have severe, debilitating chronic pain syndromes of multiple etiologies, including cancer-related pain syndromes.Objective: This study evaluated the safety and efficacy of initiating and maintaining additional methadone for chronic pain in HIV-positive patients with ongoing treatment for opiate addiction in methadone maintenance treatment programs (MMTPs).Methods: We performed a retrospective chart review of 53 HIV/AIDS patients (36 male, 17 female; 24 with cancer) with diverse chronic pain syndromes who were followed in an HIV Pain Clinic and were currently enrolled in an MMTP. The outcome measure was pain, assessed using a numeric rating scale (0-10). Incidence of heroin use was also measured.Results: The mean methadone dose initially prescribed for analgesia was approximately equal to 67 percent of the methadone dose used in the MMTP for addiction. Over the 12-month retrospective observation period, methadone was titrated to approximately 200 percent of the methadone maintenance dose. The mean pain score at initial visit to the Pain Clinic was 9.4 + 1.03. After methadone for analgesia has been administered for 1 month, the mean pain score decreased to 5.35 ± 1.7 (p < 0.001), at 3 months, 4.8 ± 1.3 (p < 0.001), at 6 months, 4.2 ± 1.7 (p < 0.001), and at 12 months, 4.2 ± 1.4 (p < 0.001). No serious adverse events or side effects were observed with methadone therapy for analgesia.Conclusion: HIV/AIDS patients with chronic pain enrolled in MMTPs achieved improved analgesia with no serious side effects when additional methadone was administered for pain relief. Further controlled studies are needed to confirm our findings and to establish the safety and efficacy of methadone therapy for chronic pain in this population.

scholarly journals Multimorbidity in Patients Enrolled in a Community-Based Methadone Maintenance Treatment Programme Delivered through Primary Care

2014 ◽  
Vol 4 (1) ◽  
pp. 46-54 ◽  
Author(s):  
Diane E. Arnold-Reed ◽  
Tom Brett ◽  
Lakkhina Troeung ◽  
Jasmine O'Neill ◽  
Rupert Backhouse ◽  
...  
Keyword(s):  
Primary Care ◽  
Disease Severity ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Rating Scale ◽  
Methadone Maintenance ◽  
Drug Abusers ◽  
Age Group ◽  
Community Based ◽  
Long Term Conditions

Background Multimorbidity, the co-existence of two or more (2+) long-term conditions in an individual, is common among problem drug abusers. Objective To delineate the patterns, multimorbidity prevalence, and disease severity in patients enrolled in a community-based primary care methadone maintenance treatment (MMT) programme. Design This was a retrospective cohort study ( n=274). The comparator group consisted of mainstream primary care patients. Electronic medical record assessment was performed using the Cumulative Illness Rating Scale. Results Prevalence of multimorbidity across 2+ domains was significantly higher within the MMT sample at 88.7% (243/274) than the comparator sample at 51.8% (142/274), p<0.001. MMT patients were seven times more likely to have multimorbidity across 2+ domains compared with mainstream patients (OR 7.29, 95% confidence interval 4.68–11.34; p<0.001). Prevalence of multimorbidity was consistently high across all age groups in the MMT cohort (range 87.8–100%), while there was a positive correlation with age in the comparator cohort ( r=0.29, p<0.001). Respiratory, psychiatric, and hepatic–pancreatic domains were the three most common domains with multimorbidity. Overall, MMT patients (mean±SD, 1.97±0.43) demonstrated significantly higher disease severity than mainstream patients (mean±SD, 1.18±0.78), p<0.001. Prevalence of moderate disease severity observed in the <45-year MMT age group was 50% higher than the ≥45-year comparator age group. Conclusions Prevalence of multimorbidity and disease severity in MMT patients was greater than in the age- and sex-matched comparators. Patients with a history of drug abuse require co-ordinated care for treatment of their addiction, and to manage and prevent chronic illnesses. Community-based programmes delivered through primary care help fulfil this need.

Outcomes of compulsory detention compared to community-based voluntary methadone maintenance treatment in Vietnam

2018 ◽  
Vol 87 ◽  
pp. 9-15 ◽  
Author(s):  
Thu Vuong ◽  
Alison Ritter ◽  
Marian Shanahan ◽  
Robert Ali ◽  
Nhu Nguyen ◽  
...  
Keyword(s):  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Community Based

Factors associated with depression and anxiety among patients attending community-based methadone maintenance treatment in China

Addiction ◽  
2014 ◽  
Vol 110 ◽  
pp. 51-60 ◽  
Author(s):  
Wenyuan Yin ◽  
Lin Pang ◽  
Xiaobin Cao ◽  
Jennifer M. McGoogan ◽  
Michael Liu ◽  
...  
Keyword(s):  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Depression And Anxiety ◽  
Community Based ◽  
Factors Associated

scholarly journals Lapse and Relapse Rates in Narcotics Anonymous Versus Methadone Maintenance Treatment: A 12-Month Prospective Study

2021 ◽  
Author(s):  
Fahimeh Mohseni ◽  
Kasra Rahimi ◽  
Mohammad Niroumand Sarvandani ◽  
Zhaleh Jamali ◽  
Seyedeh Masoumeh Seyedhosseini Tamijani ◽  
...  
Keyword(s):  
Social Support ◽  
Drug Abuse ◽  
Methadone Maintenance Treatment ◽  
Maintenance Treatment ◽  
Methadone Maintenance ◽  
Narcotics Anonymous ◽  
Phone Calls ◽  
Demographic Questionnaire ◽  
Social Support Scale ◽  
The Mean

Objective: The present study aimed to compare lapse and relapse-free survival between patients treated in Narcotics Anonymous (NA) groups and Methadone Maintenance Treatment (MMT) centers and to determine the relationship between social support scale and treatment outcome. Method: This study was a prospective, 12-month cohort study using the random sampling method to select 100 newcomer patients treated by the NA Association as well as 100 patients in MMT centers. The data were collected using a demographic questionnaire and Social Support Appraisals (SSA) scale at the onset of the study along with follow-up phone calls every other week. Results: All participants were male, aged between 18 and 65 with a mean (SD) age of 38.98 (± 10.85) years. Prevalence of relapse in 12 months was 60.5%. The lapses in the MMT group and relapses in the NA group were significantly higher (P < 0.001). The younger patients with lower levels of education are at greater risk of lapse/relapse. The mean score of SSA was significantly higher in the MMT group than the NA group in all subscales, including friends, family, and the others' support (P < 0.001). The mean scores of SSA subscales for the participants without relapse in the NA group was significantly higher in comparison to the MMT group. Conclusion: Detection of factors related to drug abuse relapse/lapse may help addiction therapists to identify drug abuse patients with lapse/relapse and to develop treatment and policy guidelines to prevent relapse in addiction recovery.

Sign in / Sign up

Export Citation Format

Share Document