Uso de reducción de daños y gravedad psicopatológica y médica en pacientes en programa de mantenimiento con metadona

Martínez-Luna, Nieves; Rodríguez-Cintas, Laia; Esojo, A.; Palma-Álvarez, Raúl Felipe; Robles-Martínez, Maria; Grau-López, Lara; Perea, Marta; Roncero, Carlos

doi:10.20882/adicciones.897

Cited by 8 publications

(7 citation statements)

References 21 publications

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“…For example, results from our descriptive analyses indicated that nearly 60% of OUD treatment participants also had a dual mental health diagnosis in the past year. This finding was expected and aligns with previous reports that dual mental health and psychiatric disorders are exceptionally high among individuals with OUD [47,48]. Importantly, additional research has pointed to the intersectional relationships between mental health problems, MMT utilization, and the experience of social inequities, in particular among MMT patients who also struggle with mental health diagnoses [49].…”

Section: Discussionsupporting

confidence: 89%

Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in U.S. healthcare settings

Pro

Zaller

2020

PLoS ONE

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BackgroundDisparities in methadone maintenance therapy (MMT) outcomes have received limited attention, but there are important negative outcomes associated with MMT that warrant investigation. Racial discrimination is common in healthcare settings and affects opioid use disorder (OUD) treatment and comorbidities. However, race/ethnicity alone may not fully explain experiences of discrimination. MMT remains highly stigmatized and may compound the effect of race/ethnicity on discrimination in healthcare settings. We sought to quantify differential associations between MMT and experiences of racial discrimination between racial/ethnic groups in a U.S. national sample. MethodsWe used the National Epidemiologic Survey on Alcohol and Related Conditions-III (2012)(2013) to identify a subset of individuals with a lifetime OUD who had ever used MMT (survey n = 766; weighted population n = 5,276,507). We used multivariable logistic regression to model past-year experience of racial discrimination in a healthcare setting. We included an interaction term between race/ethnicity and MMT status to identify the odds of discrimination (MMT vs. no MMT [referent]) within racial/ethnic groups. We used survey procedures with weights to account for the parent study's complex survey design. FindingsTwenty-two percent of our sample experienced racial discrimination in a healthcare setting in the past year. Discrimination was more common among those who had ever used MMT (x 2 = 10.00, p = 0.001) and racial/ethnic minorities (x 2 = 23.15, p<0.001). The interaction effect was much stronger than the main effects of race/ethnicity and MMT status. MMT status (versus no MMT) was positively associated with discrimination among Blacks (aOR = 3.93, 95% CI = 3.87-3.98, p<0.001), Whites (aOR = 2.25, 95% CI = 2.23-2.27, p<0.001),

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Section: Discussionsupporting

confidence: 89%

Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in U.S. healthcare settings

Pro

Zaller

2020

PLoS ONE

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“…Also, thanks to the implementation of the program, 17 new patients have been identified who, after the program ended, have been integrated with the community mental health services via referrals to their mental health teams and the addictive disorders unit and other resources in the addiction care network (outpatient drug clinics and therapeutic communities) (Volkow, 2020), which leads to their reincorporation to society, as it has been proposed (Fazel et al, 2014). There are previous experiences which suggest that damage reduction programs and low threshold programs are useful to supply patients with basic resources which could be an entry point to the general and mental health care system (Martínez-Luna et al, 2018) and are well perceived by the patients, some of them in a vulnerable situation or homeless (Daigre et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Martin

Andrés

Bullón

et al. 2020

Int J Soc Psychiatry

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Background: Homeless population has been severely affected by the COVID-19 pandemic. Their living conditions, comorbidity with different pathologies and a greater frequency of mental disorders, make this population vulnerable. Method: We implemented a program of serial visits in a hostel for confined homeless of the city council social services, for the monitoring and treatment of mental disorders and substance abuse problems. Accompanied by serial phone and email contacts. Results: A highly significant percentage (63%) had mental disorders or substance abuse, requiring pharmacological intervention, and 37% began follow-up in resources of the Mental Health and Addiction network of the Psychiatric Service at the end of the program. Hospital emergency service visits were drastically reduced. None of them were infected with COVID-19. An individualized Social plan was drawn up in order to reintegrate them with support in the community. Conclusions: The Results have been really positive, meeting all the objectives and opening up developing new programs in the future, in the pandemic outbreak and out of it.

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“…Respecto a los programas de PMM en usuarios de drogas por vía parenteral, son estadísticamente más frecuentes en malos adherentes en el análisis bruto, pero no resulta significativa esta asociación en el análisis multivariante. Este hallazgo difiere de los sugerido por otros autores (Malta, Strathdee, Magnanini y Bastos, 2008), y podría deberse a que, en nuestra muestra, el perfil de paciente en PMM se corresponde con un peor nivel socioeconómico y situación clínica, lo cual sería congruente con los hallazgos de otros estudios (Martínez-Luna et al, 2018;Pedrero-Pérez y Grupo MethaQoL, 2017).…”

Section: Discussionunclassified

Influencia del consumo de sustancias y el deterioro cognitivo en la adherencia al tratamiento antirretroviral en pacientes VIH+

et al. 2018

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Uso de reducción de daños y gravedad psicopatológica y médica en pacientes en programa de mantenimiento con metadona

Cited by 8 publications

References 21 publications

Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in U.S. healthcare settings

Interaction effects in the association between methadone maintenance therapy and experiences of racial discrimination in U.S. healthcare settings

COVID pandemic as an opportunity for improving mental health treatments of the homeless people

Influencia del consumo de sustancias y el deterioro cognitivo en la adherencia al tratamiento antirretroviral en pacientes VIH+

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