Are Methadone Counselors Properly Equipped to Meet the Palliative Care Needs of Older Adults in Methadone Maintenance Treatment? Implications for Training

Abstract

Today's methadone patients differ greatly from those of the past. Because of the rise of polydrug use and the HIV and hepatitis epidemics, treatment has become much more complex, which multiply the concerns and complexities of treatment. Patients entering methadone programs are also more commonly presenting at ages well into their 50s, 60s, and 70s; and this phenomenon of high rates continues to grow. The majority of these individuals in treatment have presented with a number of significant comorbid medical conditions that will progress and eventually lead to death. This aging cohort must be approached with a modified treatment plan that focuses on management and promoting healthy aging, while attending to their maximum delay of illness, disease, and disability. This article argues that it is necessary for counselors working with this group to adopt a palliative care philosophy. This article also makes recommendations in areas that counselors need to be knowledgeable and skilled in to provide appropriate palliative services specific to this aging population with multiple needs as they near end of life.

Ageing and older people who use illicit opioids, cocaine or methamphetamine: a scoping review and literature map

“…Most publications used ‘quality of life’ as a general term to encompass many facets of health and wellbeing (e.g. Doukas, 2014) [103]. Only one publication specifically operationalized quality of life, using subscales including overall social support, personal wellbeing, and satisfaction with life [104].…”

“…Publication counts are not mutually exclusive, as publications could discuss multiple content areas. This diagram is simplified for the sake of visual clarity; additional levels of content area breakdown are provided in the Supporting information [103]. Only one publication specifically operationalized quality of life, using subscales including overall social support, personal wellbeing, and satisfaction with life [104].…”

Adultos mayores en tratamiento con metadona: posición socioeconómica y cronicidad

“…In the studies describing the diseases affecting this population, a great number of comorbidities were reported (Doukas, 2014;Gutiérrez-Cáceres et al, 2019;Hamilton & Grella, 2009;Searby et al, 2015), both physical, such as high blood pressure which was significantly greater in men than in women (Rosen et al, 2008), and mental problems, where 40% of those interviewed had dual pathology (Notley et al, 2015), depression being the most common diagnosis (Mortazavi et al, 2015), especially among women (Rosen et al, 2008).…”

“…The articles showed that studies no longer solely examine population characteristics, prevalence, and mortality (Gutiérrez-Cáceres et al, 2019;Notley et al, 2015), but also the points of view of patients in treatment: their preferences regarding health care professionals (Conner et al, 2010), the type of treatment and levels of satisfaction with the latter, including the opinions of carers (Guo et al, 2010). Other studies recommended the use of a specific therapy, such as Problem-Solving Therapy, adapted as necessary to the specific needs of the study population , or envisaged future needs such as palliative care (Doukas, 2014).…”

“…These treatments, that began as a harm reduction strategy (Mattick et al, 2009), have become chronic with the increase in mean years of duration, owing to which the original aims no longer fit the current needs of patients who, having aged, require assistance to stay healthy and preserve their quality of life (Doukas, 2014;Gol-Montserrat et al, 2018;Weiss & Rao, 2017).…”