Colombia has experienced a dramatic increase of heroin use in the last 3 decades, stablishing the first methadone maintenance treatment (MMT) program in 2004. Although international evidence indicates that MMT has important benefits for people with opioid use disorder, technical and logistical difficulties have been identified in Colombia that can compromise the effectiveness of this treatment modality. In this cross-sectional study, a total of 148 subjects with opioid use disorder were interviewed in the city of Armenia (Colombia) using the Opiate Treatment Index, comparing the drug use, social functioning, human immunodeficiency virus risk behaviors, criminal activity, and the physical/mental health among subjects involved in MMT and those not receiving treatment. Despite the above-mentioned difficulties, subjects participating in MMT reported less illegal substance use (specifically heroin and basuco), less human immunodeficiency virus risk behaviors, better social functioning, less criminal activity, and less physical and mental health problems than those not receiving treatment. In addition, subjects involved in MMT reported a daily use of heroin and lower than recommended dosages of methadone. Therefore, Colombia should continue expanding MMT programs across the country, integrating the available harm reduction strategies and providing continuous training for health professionals in charge of these programs.
INTRODUCCION La Patología Dual (PD) en el consumo de alcohol condiciona el pronóstico, adherencia y retención en la intervención ambulatoria. OBJETIVOS Conocer prevalencia de patología dual. Determina tasas de adherencia a consulta y tratamiento. Analizar correlación PD cumplimiento y efectividad terapéutica. METODO Estudio descriptivo observacional longitudinal. Referencia muestral: 77 pacientes con TUA de 472 incluidos en Plan de Microeliminación del VHC de San Miguel Adicciones (2017 a 2020). Variables de estudio: sociodemográficas, clínicas y de consumo e indicadores de cumplimiento y retención. RESULTADOS Muestra: 62% hombres y 38% mujeres (34 y 70 años). 52% Patología Dual (69%M; 42%H). Patologías psiquiátricas: 22% trastorno depresivo (53%H;47%M), 7% ansiedad (60%H;40%M), 8% síndrome ansioso depresivo (34%H;66%M). Tentativas autolíticas 16%, (42%H;58%M), 7% más de un trastorno psiquiátrico. Acuden por Iniciativa Propia 49%, derivación MAP (25%), Especializada 9%. La retención es superior en los pacientes que no tienen PD (>12 meses). Menor índice de retención en pacientes con trastorno psiquiátrico 40%. Trastorno Depresivo: 82% de adherencia a consulta (AC), 47% de retención (R) > 6 meses, 29% abandona (A) y 24% alta terapéutica (AT). Trastorno de Ansiedad: 20%(AC), 60% (R) >6 meses, 40% (A), 0% (AT). Trastorno Ansioso-Depresivo: 10% (AC), 67%(R) > 6 meses, 50% (A) y 33% (AT). CONCLUSIONES Predominio de trastornos afectivos: depresión, ansiedad. Diferencia en el factor género en TUA y PD. Prevalencia de más de un Trastorno Mental superior en mujeres. Escasa derivación desde los Servicios Especializados. La concurrencia PD-TUA incide de manera desfavorable en pronóstico, evolución y efectividad terapéutica. References 1. Corrêa Filho JM, Baltieri DA. Psychosocial and clinical predictors of retention in outpatient alcoholism treatment. Braz J Psychiatry. 2012 -12;34(4):413-21. 2. Graff FS, Morgan TJ, Epstein EE, McCrady BS, Cook SM, Jensen NK, et al. Engagement and retention in outpatient alcoholism treatment for women. Am J Addict. 2009 Jul-Aug;18(4):277-88.
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