A controlled trial of methadone treatment combined with directly observed isoniazid for tuberculosis prevention in injection drug users

Batki, Steven L.; Gruber, Valerie A.; Bradley, Julia Moon; Bradley, Mark; Delucchi, Kevin

doi:10.1016/s0376-8716(01)00208-3

Cited by 64 publications

(55 citation statements)

References 48 publications

(41 reference statements)

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“…This study was primarily designed to test the effects of methadone maintenance on adherence to six months of directly observed tuberculosis (TB) chemoprophylaxis with isoniazid. As described in Batki et al (2002), heroin dependent patients with latent TB who received methadone maintenance, even with only minimal counseling, were more likely to complete the six-month TB preventive therapy than those who received only 21-day methadone detoxification with monthly visits to a TB clinic. As the earlier report focused on the main findings and did not describe other outcomes, the present report focuses on the effects of the six-month methadone maintenance with different counseling intensities on substance use and psychosocial outcomes.…”

Section: Study Aimsmentioning

confidence: 97%

“…Morral et al, 1999). Indeed, only 36% of participants stated they wanted to stop using heroin; most were hoping to continue using heroin, but to use less and or use more safely (Batki et al, 2002). This population may benefit from motivational interviewing (Miller and Rollnick, 2002;) or contingency management (Elk et al, 1995).…”

Section: Interpretation Of Findingsmentioning

confidence: 99%

“…This study was designed primarily to test the effectiveness of methadone maintenance in increasing completion of six months of TB preventive therapy (as described in Batki et al, 2002). The study also allowed analysis of the effects of six-month methadone maintenance with differing amounts of counseling on substance use and related outcomes.…”

Section: Designmentioning

confidence: 99%

“…(Batki et al, 2002), patients with opioid dependence were recruited from an outpatient 21-day methadone detoxification program and were randomly assigned to one of three treatment conditions: 1) continuation in 21-day methadone detoxification; 2) transfer to six-month methadone maintenance with only minimal counseling; or 3) transfer to six-month methadone maintenance with standard twice monthly counseling and as-needed social work and psychiatric services. Both of the six-month maintenance treatments were followed by 1.5 months of detoxification.…”

mentioning

confidence: 99%

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A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

Gruber

Delucchi

Kielstein³

et al. 2008

Drug and Alcohol Dependence

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Background-Important questions remain regarding the necessary duration and intensity for methadone treatment to be effective. (Batki et al., 2002), patients with opioid dependence were recruited from an outpatient 21-day methadone detoxification program and were randomly assigned to one of three treatment conditions: 1) continuation in 21-day methadone detoxification; 2) transfer to six-month methadone maintenance with only minimal counseling; or 3) transfer to six-month methadone maintenance with standard twice monthly counseling and as-needed social work and psychiatric services. Both of the six-month maintenance treatments were followed by 1.5 months of detoxification. Urine drug tests and self-report measures were collected at baseline, months 1 through 6, and month 8.5. Methods-As part of a clinical trial of tuberculosis chemoprophylaxisResults-Compared to 21-day methadone detoxification, six-month methadone maintenance with either minimal or standard counseling resulted in fewer opiate positive urine tests and days of selfreported heroin and alcohol use. There was no change in cocaine use or other outcome measures. The increased counseling available in the standard counseling condition did not appear to reduce heroin use further than the minimal counseling condition, in contrast to the effect found for more structured counseling in long-term methadone maintenance (McLellan et al., 1993).Conclusions-Six months of methadone maintenance, even with minimal counseling, reduces heroin and alcohol use more than 21-day methadone detoxification.

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Section: Study Aimsmentioning

confidence: 97%

Section: Interpretation Of Findingsmentioning

confidence: 99%

Section: Designmentioning

confidence: 99%

mentioning

confidence: 99%

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A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

Gruber

Delucchi

Kielstein³

et al. 2008

Drug and Alcohol Dependence

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“…5,7,34 Additionally, substance abuse has been found to be associated with poor adherence to treatment regimens. 16,25,48 Poor treatment adherence identifies perhaps the strongest argument for developing targeted and sustainable TB prevention efforts directed toward substance abusers, especially among those that are homeless. Environmental and behavioral risk factors can predispose homeless persons to conversion of latent infection into active disease, 15,16 which, in turn, has a high potential for becoming multidrug resistant due to poor adherence to treatment regimens.…”

Section: Injection Drug Usementioning

confidence: 99%

Tuberculosis Knowledge, Perceived Risk and Risk Behaviors Among Homeless Adults: Effect of Ethnicity and Injection Drug Use

Nyamathi

Sands

Pattatucci-Aragón

et al. 2004

Journal of Community Health

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The objectives of this study were to investigate Tuberculosis (TB) knowledge, perceived risk, and risk behaviors in a sample of homeless persons with latent TB in the Skid Row district of Los Angeles. Particular emphasis was given to comparing these variables among homeless persons of varying ethnic backgrounds and among those who did and did not report a history of injection drug use (IDU). Baseline data were collected from 415 homeless individuals recruited to participate in a Tuberculosis chemoprophylaxis intervention. Areas of interest relative to TB knowledge and perceived risk for infection were behavioral factors surrounding substance use and abuse; personal factors measured in terms of current depression; and sociodemographic and situational factors, such as age, ethnicity, history of incarceration, and duration of homelessness. Findings revealed differences in substance abuse. IDUs were more likely to have histories of daily drug use and alcohol dependency, but were less apt to report recent use of crack cocaine. TB knowledge deficits centered on ignorance with respect to modes of transmission and risk factors for TB infection. IDU was also associated with depression. Latinos and IDUs were most likely to lack TB knowledge. There is a pressing need for accessible, available, culturally acceptable and sustained TB screening and intervention programs designed to address multiple risk factors and knowledge deficits with respect to TB infection in homeless populations.

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Tuberculosis and Substance Abuse in the United States, 1997-2006

Oeltmann¹,

Kammerer²,

Pevzner³

et al. 2009

Arch Intern Med

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Substance abuse is the most commonly reported behavioral risk factor among patients with TB in the United States. Patients who abuse substances are more contagious (eg, smear positive) and remain contagious longer because treatment failure presumably extends periods of infectiousness. Increased transmission is consistent with our finding that patients who abuse substances were more likely to be involved in a localized genotype cluster, which can represent recent transmission.

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A controlled trial of methadone treatment combined with directly observed isoniazid for tuberculosis prevention in injection drug users

Cited by 64 publications

References 48 publications

A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

Tuberculosis Knowledge, Perceived Risk and Risk Behaviors Among Homeless Adults: Effect of Ethnicity and Injection Drug Use

Tuberculosis and Substance Abuse in the United States, 1997-2006

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