The Prevalence and Pattern of Cannabis Use Among Patients Attending a Methadone Treatment Clinic in Nairobi, Kenya

Abstract Background: Cannabis use during methadone treatment may negatively impact treatment outcomes. The aim of this study was to determine the prevalence and pattern of cannabis use among patients attending a methadone treatment clinic in Nairobi, Kenya. Methods: This was a retrospective study of 874 patients on methadone therapy at a methadone maintenance treatment clinic in Nairobi, Kenya from December 2014 to November 2018. Data on sociodemographic characteristics and drug use patterns based on urine drug screens was collected from patient files. Data was analyzed using Statistical Package for the Social Sciences (SPSS) for windows version 23.0. Results: Prevalence of cannabis use was 85.8% (95% CI, 83.3 – 88.0) at baseline and 62.7% (95% CI, 59.5 – 65.8) during follow up. A pattern of polysubstance use was observed where opioids, cannabis and benzodiazepines were the most commonly used drugs. The mean age of the patients was 35.3 (SD 9.0) years with majority being male, unemployed (76%), had primary level of education (51.4%) and divorced or separated (48.5%). Cannabis use was associated with dropping out of treatment (p=0.001) and university education was associated with reduced risk for cannabis use OR=0.1 (95% CI, 0.02-0.8, p=0.031). Conclusion: Cannabis use is prevalent among patients attending a methadone treatment clinic in Kenya and is associated with dropping out of treatment. There is a need for targeted interventions to address the problem of cannabis use during methadone maintenance treatment in Nairobi, Kenya.

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Cannabis Use Among Patients Attending A Methadone Maintenance Treatment Clinic In Nairobi, Kenya

10.21203/rs.3.rs-63021/v1 ◽

2020 ◽

Author(s):

Elizabeth Wambui Ngarachu ◽

Sarah Kanana Kiburi ◽

Frederick R. Owiti ◽

Rachel N. Kangethe

Keyword(s):

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Methadone Treatment ◽

Opioid Use Disorder ◽

Cannabis Use ◽

Opioid Use ◽

Loss To Follow Up ◽

Treatment Clinic

Abstract Background: Cannabis use is common among patients with opioid use disorder receiving methadone treatment. Research has shown that cannabis use during methadone treatment may impact negatively on treatment outcome. This study aimed at determining the prevalence and pattern of cannabis use and the associated socio-demographic characteristics among patients on methadone treatment. Methods: This was a retrospective study of 984 patients on methadone therapy at a methadone maintenance treatment clinic in Nairobi, Kenya. Data on socio-demographic characteristics and drug use patterns based urine drug screens was collected from patients’ files. Data was analyzed using SPSS for windows version 23.0. Results: Prevalence of cannabis use was 84.8% at baseline and 62.8% during follow up. Polysubstance use pattern was observed with heroin, cannabis and benzodiazepines being the commonest drugs. Majority of cannabis users were male (88.1%), aged 28-37 years (42.2%), unemployed (74.3%), had low level of education (87.7%) and single (72.4%). Cannabis use was associated with loss to follow up (p<0.001). Females were more likely to drop out of treatment and less likely to stop using cannabis during follow up compared to males. Sociodemographic factors associated with reduced risk for cannabis use were; being in older age group 48-57 years (OR 0.51, 95%CI, 0.30-0.87, p=0.013) and university education (OR 0.15, 95%CI, 0.05-0.69, p=0.005) while being in age group 18-27 years and being married were associated with increased risk for cannabis use (OR 2.62,95%CI, 1.78-3.86,p=0.001 and OR 1.50, 95%CI, 1.7-2.10,p=0.021 respectively). Conclusion: There is a prevalence of cannabis use among patients in receiving methadone treatment in Kenya is similar. In addition, cannabis use was associated with loss to follow up and sociodemographic characteristics. Cannabis use screening and targeted interventions for management should be incorporated in methadone treatment programs to improve outcomes for patients on methadone. Key words : cannabis, opioid use disorder, methadone maintenance treatment, Kenya

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Cannabis Use and Nonfatal Opioid Overdose among Patients Enrolled in Methadone Maintenance Treatment

Substance Use & Misuse ◽

10.1080/10826084.2021.1892137 ◽

2021 ◽

Vol 56 (5) ◽

pp. 697-703

Author(s):

William C. Bryson ◽

Benjamin J. Morasco ◽

Brandi P. Cotton ◽

Stephen M. Thielke

Keyword(s):

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Cannabis Use ◽

Opioid Overdose

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Association study of genetic polymorphisms in GABRD with treatment response and dose in methadone maintenance treatment

Personalized Medicine ◽

10.2217/pme-2021-0063 ◽

2021 ◽

Author(s):

Xiaohu Xie ◽

Jun Gu ◽

Dingding Zhuang ◽

Xiaoyu Chen ◽

Yun Zhou ◽

...

Keyword(s):

Treatment Response ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Methadone Treatment ◽

Heroin Addiction ◽

High Dose ◽

Nucleotide Polymorphisms ◽

Single Nucleotide ◽

Delta Subunit

Aim: This study determined if gene variants in the GABA receptor delta subunit ( GABRD) are associated with treatment response and dose in methadone maintenance treatment (MMT) for heroin addiction. Materials & methods: A total of 286 MMT patients were recruited and divided into response and nonresponse groups based on retention time in therapy. A total of 177 responders were classified into low dose and high dose subgroups according to the stabilized methadone dose. Four (single nucleotide polymorphisms) SNPs (rs13303344, rs4481796, rs2376805 and rs2229110) in GABRD were genotyped using the TaqMan SNP assay. Logistic regression was used to assess the genetic effects of the SNPs in MMT. Results: No significant associations were observed between the SNPs and treatment response or dose, except the frequency of haplotype ACGC at the four SNPs significantly differed between responders and nonresponders. Conclusion: The results indicated that GABRD variants may play a small role in modulating methadone treatment response.

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The association between health conditions and cannabis use in patients with opioid use disorder receiving methadone maintenance treatment

BJPsych Open ◽

10.1192/bjo.2019.78 ◽

2019 ◽

Vol 5 (6) ◽

Author(s):

Ieta Shams ◽

Nitika Sanger ◽

Meha Bhatt ◽

Tea Rosic ◽

Candice Luo ◽

...

Keyword(s):

Anxiety Disorders ◽

Methadone Maintenance Treatment ◽

Odds Ratio ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Current Treatment ◽

Opioid Use Disorder ◽

Cannabis Use ◽

Health Conditions ◽

Opioid Use

Background Cannabis is the most commonly used substance among patients in methadone maintenance treatment (MMT) for opioid use disorder. Current treatment programmes neither screen nor manage cannabis use. The recent legalisation of cannabis in Canada incites consideration into how this may affect the current opioid crisis. Aims Investigate the health status of cannabis users in MMT. Method Patients were recruited from addiction clinics in Ontario, Canada. Regression analyses were used to assess the association between adverse health conditions and cannabis use. Further analyses were used to assess sex differences and heaviness of cannabis use. Results We included 672 patients (49.9% cannabis users). Cannabis users were more likely to consume alcohol (odds ratio 1.46, 95% CI 1.04–2.06, P = 0.029) and have anxiety disorders (odds ratio 1.75, 95% CI 1.02–3.02, P = 0.043), but were less likely to use heroin (odds ratio 0.45, 95% CI 0.24–0.86, P = 0.016). There was no association between cannabis use and pain (odds ratio 0.98, 95% CI 0.94–1.03, P = 0.463). A significant association was seen between alcohol and cannabis use in women (odds ratio 1.79, 95% CI 1.06–3.02, P = 0.028), and anxiety disorders and cannabis use in men (odds ratio 2.59, 95% CI 1.21–5.53, P = 0.014). Heaviness of cannabis use was not associated with health outcomes. Conclusions Our results suggest that cannabis use is common and associated with psychiatric comorbidities and substance use among patients in MMT, advocating for screening of cannabis use in this population. Declaration of interest None.

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Polysubstance Use among Patients Enrolling in Methadone Maintenance Treatment Program in a Vietnam Province with Drug-Driven HIV Epidemic

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16183277 ◽

2019 ◽

Vol 16 (18) ◽

pp. 3277 ◽

Cited By ~ 5

Author(s):

Tuan Anh Le ◽

Duyen T. T. Pham ◽

Travis T. C. Quek ◽

Giang Thu Vu ◽

Chi Linh Hoang ◽

...

Keyword(s):

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Illicit Drugs ◽

Methadone Maintenance ◽

Health Sector ◽

Peer Pressure ◽

Cross Sectional Study ◽

Cross Sectional ◽

Polysubstance Use ◽

Suboptimal Adherence

Methadone maintenance treatment (MMT) has been scaled up significantly in recent years. This study aimed to investigate the pattern of polysubstance use in 395 MMT patients and its contextualized associated factors. A cross-sectional study was performed in three outpatient MMT clinics in Nam Dinh Province. Multivariate Poisson regression was used to identify factors associated with polysubstance use status. The mean MMT duration and the current MMT dose was 3.3 years and 69.2 mg, respectively. Among participants, 24.8% reported daily alcohol use, 68.6% smoked regularly, and 6% used illicit drugs. Peer pressure and MMT suboptimal adherence were found to associate with continual usage of drugs (47.8%). Participants who lived with a spouse/partner, were self-employed, and smoked were more likely to drink alcohol. Those who drink were also more likely to smoke, and vice versa. Recommendations for policymakers include community-based education and promotional programs aiming to decrease substance usage in the community as well as encouraging and supporting the private health sector in establishing private MMT services and clinics. Further longitudinal studies on polysubstance usage among MMT patients should also be conducted.

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Association between cannabis use and treatment outcomes in patients receiving methadone maintenance treatment: a systematic review protocol

Systematic Reviews ◽

10.1186/s13643-016-0317-2 ◽

2016 ◽

Vol 5 (1) ◽

Cited By ~ 8

Author(s):

Laura Zielinski ◽

Meha Bhatt ◽

Rebecca B. Eisen ◽

Stefan Perera ◽

Neera Bhatnagar ◽

...

Keyword(s):

Systematic Review ◽

Treatment Outcomes ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Cannabis Use ◽

Systematic Review Protocol ◽

Review Protocol

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Development of a Brief Treatment Instrument for Routine Clinical Use with Methadone Maintenance Treatment Clients: The Methadone Treatment Index

Substance Use & Misuse ◽

10.1080/10826080802116098 ◽

2008 ◽

Vol 43 (11) ◽

pp. 1666-1680

Author(s):

Daryle E. Deering ◽

J. Douglas Sellman ◽

Simon J. Adamson ◽

Jacqueline Horn ◽

Christopher M. A. Frampton

Keyword(s):

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Methadone Treatment ◽

Clinical Use ◽

Brief Treatment

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Predictors of Treatment Retention in Enhanced and Standard Methadone Maintenance Treatment for HIV Risk Reduction

Journal of Drug Issues ◽

10.1177/002204269702700202 ◽

1997 ◽

Vol 27 (2) ◽

pp. 203-224 ◽

Cited By ~ 23

Author(s):

Christine E. Grella ◽

Stuart E. Wugalter ◽

M. Douglas Anglin

Keyword(s):

Hiv Risk ◽

Methadone Maintenance Treatment ◽

Maintenance Treatment ◽

Methadone Maintenance ◽

Methadone Treatment ◽

Early Discharge ◽

The Public ◽

Methadone Maintenance Treatment Program ◽

First 90 Days ◽

Hiv Seropositive

Survival analysis was used to determine the predictors of discharge from a methadone maintenance treatment program for heroin addicts at high-risk for HIV infection and/or transmission. A consistent set of predictors was identified that was associated with treatment discharge at 90 days, 12 months, 18 months, and 24 months. Individuals who, at intake, were HIV seropositive, were younger, used cocaine, drank alcohol daily, and scored high on measures of depression and interpersonal problems were at a higher risk for discharge. Receipt of enhanced methadone treatment, which included case management services, group participation, psychiatric services, contingency-based reinforcers, and transportation assistance, was associated with a higher probability of retention, particularly in the first 90 days. These findings can be used to target individuals who are vulnerable to early discharge from treatment and to provide adjunctive services that may improve retention. Several of these predictors, particularly cocaine use and psychological problems, have also been associated with HIV risk among methadone clients. Increasing retention in methadone treatment will not only improve treatment efficacy but will also address the public health imperative to limit the transmission of HIV.

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