A 5-year evaluation of a methadone medical maintenance program

Abstract

Methadone medical maintenance (MMM) is a model for the treatment of opioid dependence in which a monthly supply of methadone is distributed in an office setting, in contrast to more highly regulated settings where daily observed dosing is the norm. We assessed patient characteristics and treatment outcomes of an MMM program initiated in the Bronx, New York, in 1999 by conducting a retrospective chart review. Participant characteristics were compared with those of patients enrolled in affiliated conventional methadone maintenance treatment programs. Patients had diverse ethnicities, occupations, educational backgrounds, and income levels. Urine toxicology testing detected illicit opiate and cocaine use in 0.8% and 0.4% of aggregate samples, respectively. The retention rate was 98%, which compares favorably with the four other MMM programs that have been reported in the medical literature. This study demonstrates that selected patients from a socioeconomically disadvantaged population remained clinically stable and engaged in treatment in a far less intensive setting than traditional methadone maintenance.

Trends in methadone maintenance treatment participation, retention, and compliance to dosing guidelines in British Columbia, Canada: 1996–2006

“…In BC, carries are more often prescribed in rural areas and may be a necessary component in the reintegration of clients into society, as copayments are required once an individual gains employment. Several studies conducted in the United States have demonstrated success with "methadone medical maintenance" prescribing long carries (up to 1 month) in stabilized, responsive patients (Harris et al, 2006). Evidence on the public safety issues regarding carry prescriptions should be balanced against evidence that supports their effectiveness.…”

Traitement de la dépendance aux opioïdes : évaluation d’un projet montréalais de transfert d’usagers stabilisés vers des soins de santé généraux

“…Le traitement de substitution aux opioïdes a fait l'objet de très nombreuses évaluations et son efficacité a pu être démon-trée dans plusieurs contextes culturels différents (Fiellin & al., 2001 ;Gruer & al., 1997 ;Harris & al., 2006 ;Langendam & al., 1998 ;McMurphy, Shea, Switzer, & Turner, 2006 ;Merrill & al., 2004 ;Plomp, Van Der Hek, & Herman, 1996 ;Sheridan, Goodyear-Smith, Butler, Wheeler, & Gohns, 2008 ;Wittchen & al., 2008). Ce traitement consiste à proposer un produit de remplacement qui pénètre progressivement dans l'organisme, qui ne produit pas de sensation euphorisante et qui maintient le consommateur dans un état fonctionnel (Paquin, 2003).…”

“…La situation rapportée semble correspondre en plusieurs points à celle observée aux États-Unis en rapport avec la légis-lation fédérale qui encadre le traitement de substitution (Fiellin & al., 2001 ;Fiellin, O'Connor, Chawarski, & Schottenfeld, 2004 ;Harris & al., 2006 ;King & al., 2006 ;McMurphy, Shea, Switzer, & Turner, 2006 ;Merril & al., 2004). Ces politiques visent à prévenir la vente illégale des médications de substitution et à assurer la présence d'un accompagnement psychosocial à la pharmacothérapie (Harris & al., 2006).…”

“…Ces politiques visent à prévenir la vente illégale des médications de substitution et à assurer la présence d'un accompagnement psychosocial à la pharmacothérapie (Harris & al., 2006). Depuis 2002, les omnipraticiens américains ont la possibilité de prescrire le traitement de substitution à la buprénorphine (McMurphy, Shea, Switzer, & Turner, 2006).…”

Sensitive determination of methadone in human serum and urine by dispersive liquid–liquid microextraction based on the solidification of a floating organic droplet followed by HPLC–UV

“…The mechanism of action by which MET can alleviate opioid dependence and diminishing symptoms in affected individuals, have been discussed thoroughly [4][5][6][7][8]. MET has also been used for the relief of moderate-to-severe pain [9][10][11][12][13][14]. Thus, the increased use and availability of the drug might explain the more frequent MET overdose cases in children and adults [15][16][17].…”