Absence of Antibody to Human Immunodeficiency Virus in Long-term, Socially Rehabilitated Methadone Maintenance Patients

Novick, David M.; Joseph, Herman; Croxson, T. Scott; Salsitz, Edwin A.; Wang, Grace; Richman, Beverly L.; Poretsky, Leonid; Keefe, Janet B.; Whimbey, Estella

doi:10.1001/archinte.1990.00390130099014

Cited by 95 publications

(22 citation statements)

References 14 publications

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“…The magnitude of this reduction depends on the ability of methadone programs to reduce illicit opiate injecting. [1][2][3][4][5] The Amsterdam "low-threshold" methadone programs endeavor to take down the barriers that treatment programs and/or methadone maintenance programs6,7 put up for drug users (DUs) by not prohibiting illicit use of opiates or other drugs. This enables these programs to contact many active DUs who do not want to quit drug use.…”

Section: Introduction Methodsmentioning

confidence: 99%

HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in Amsterdam.

Hartgers¹,

Hoek²,

Krijnen³

et al. 1992

Am J Public Health

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INTRODUCTION. After the onset of the HIV epidemic, the hope arose that the "harm reduction" approach of the Amsterdam "low-threshold" methadone programs would have a function in controlling the spread of HIV among injecting drug users (IDUs). METHODS. To find evidence for this assumption, 386 IDUs participating in an HIV study between 1985 and 1989 were studied. Long-term regular participants in low-threshold methadone programs were compared with short-term and/or irregular participants. RESULTS. Controlling for possible confounders, long-term regular participants had a slightly increased but not statistically significant risk of being HIV infected. With regard to current drug use, they injected daily and shared needles as often as did short-term and/or irregular participants. CONCLUSIONS. The results suggest that the Amsterdam low-threshold methadone programs fail to diminish HIV risk behavior. If these programs want to have a positive effect on the spread of HIV, expansion of existing HIV prevention efforts, an increase in the daily methadone dose level, and measures to enforce regular attendance may be required.

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Section: Introduction Methodsmentioning

confidence: 99%

HIV prevalence and risk behavior among injecting drug users who participate in "low-threshold" methadone programs in Amsterdam.

Hartgers¹,

Hoek²,

Krijnen³

et al. 1992

Am J Public Health

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“…Evidence accumulated over many years shows that stable methadone maintenance patients who withdraw from methadone have relapse rates approaching 80-85 % within 1 year [23]. In methadone-maintained patients, there are demonstrated reductions in death rates [24], reductions in the rates of intravenous drug use [23], reductions in crime [5,25,26], and reductions in rates of HIV seroconversion [27,28]. During 1983-84 the prevalence of HIV infection in untreated heroin addicts in New York City was 50-60 %, while only 9 % of methadone maintenance patients had the HIV-1 antibody [29].…”

Section: Methadone Maintenance Effectivenessmentioning

confidence: 99%

Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”

Salsitz

Wiegand

2015

J. Med. Toxicol.

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Methadone maintenance therapy (MMT), a pharmacological treatment for opioid use disorder for the past 50 years, continues to remain controversial. Despite consistent and overwhelming evidence confirming the effectiveness and safety of MMT, misconceptions and myths persist regarding its legitimacy as a treatment for opioid addiction. This often results in the underutilization and limited availability of this treatment modality. Despite successful outcomes, the controversial nature of MMT, and the stigma experienced by the patients on methadone, has been a particularly difficult obstacle to overcome. We present the history of MMT, review the evidence for its efficacy in the treatment of opioid dependence, and explore the origins of the stigma and misconceptions related to MMT.

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“…[22][23][24][25][26][27][28] In turn, fewer injectionrelated HIV risk behaviors lead to fewer infections. [29][30][31][32][33][34][35][36][37][38] Two independent and comprehensive reviews of the literature on substance abuse treatment as HIV prevention reach essentially the same conclusions, that there is substantial and convincing evidence that substance abuse treatment interrupts patterns of drug use sufficiently to reduce risk behaviors and infections with HIV. [39][40] The most widely available and familiar form of substance abuse treatment intervention for drug users globally is drug detoxification.…”

Section: Substance Abuse Treatmentmentioning

confidence: 99%