Earning “Take-Home” Privileges and Long-Term Outcome in a Methadone Maintenance Treatment Program

Abstract

The group with the shortest time (3 to 6 months) to the achievement of first take-home dose had the best outcome. Further studies are needed to characterize this group.

Achievement of take-home dose privileges is associated with better-perceived sleep and with cognitive status among methadone maintenance treatment patients

“…We had reported that patients who managed to achieve even one THD had longer retention in MMT, and those who achieved their fi rst THD the quickest, had the best outcome (Peles et al 2011a). They also showed as would be expect, that the patients with a higher number of THD were with better characteristics than those with a lower THD number or no-THD at all.…”

“…The policy of the Adelson MMT Clinic to dispense " take-home " has already been described (Peles et al 2011a). The minimal threshold requirement is for a minimum of 3 months with no drugs in urine in order to achieve the fi rst THD, 8 months to achieve 1 week (6-THD) and more than 2 years to achieve the maximal THD of 2 weeks (13-THD).…”

“…Each patient ' s random and observed twice-monthly urine tests during the study period were analysed for THD As has already been reported (Peles et al 2011a) following the fi rst " take-home " dose at a minimum of 3 months since admission to MMT, each additional dose may be achieved following another month of full compliance with regulations, up to a total of fi ve consecutive doses. Achieving the sixth dose, which means attending the clinic only once a week, can be reached only after a minimum of 8 months since the beginning of the process and in addition, being involved in some kind of vocational activity, while 13 doses (the maximal possible " take-home " privileges allowed by the Israeli Ministry of Health ' s policy) may be achieved following a minimum of 2 years of adherence to guidelines.…”

Evaluation of a Pilot Medication-Assisted Therapy Program in Kazakhstan: Successes, Challenges, and Opportunities for Scaleup

“…The unregistered status of methadone in Kazakhstan does not allow for take-home doses, and as a result MAT is often interrupted when patients must undergo inpatient treatment in other medical facilities or move away from their home cities. Such restrictive dispensing policy is maintained despite a growing body of evidence that take-home doses of methadone improve treatment outcomes and reduce health care costs [3, 33, 34]. In addition MAT is not available in the penitentiary system, which not only results in treatment interruption for incarcerated patients but also seriously limits the health care system's ability to control HIV and other blood-borne diseases among opioid dependent prison population.…”

Methadone maintenance patients show a selective deficit to reverse positive outcomes in drug-related conditions compared to medication free prolonged opiate abstinence

“…Therefore we did not exclude them from the study. Importantly, all the participants in the methadone maintenance group fulfilled the American Society of Addiction Medicine (ASAM) criteria for take-home dose privilege, which include 3 month of abstinence together with an indication that the patient is stable, and responsible to keep the dose safe at home and drink it at due time (Peles et al, 2011). Exclusion criteria included age above 55 and positive urine for any drugs in the last 3 months.…”