High Abstinence Rates in Heroin Addicts by a New Comprehensive Treatment Approach

Jong, C.A.J. de; Roozen, Hendrik G.; Rossum, L.G.M. van; Krabbe, Paul F M; Kerkhof, A.J.F.M.

doi:10.1080/10550490601184472

Cited by 35 publications

(30 citation statements)

References 35 publications

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“…Most studies that have assessed QoL among substance users remain limited to aspects of health-related QoL (HRQOL) (De Jong et al 2007;Garg et al 1999;Rudolf and Watts 2002;Torrens et al 1997), despite the fact that several authors have demonstrated that QoL is a broader and therefore more useful concept (Boevink et al 1995;Cummins 2005;Schalock 1996). HRQOL is a subjective measure of people's mental and physical health and its influence on their functional status (Farquhar 1995;Millson et al 2004;Mooney 2006).…”

Section: Introductionmentioning

confidence: 99%

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

2008

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In drug treatment outcome literature, a focus on objective and socially desirable indicators of change (e.g. no drug use) has predominated, while outcome indicators that are important for drug users themselves (e.g. quality of life, satisfaction with treatment) have largely been neglected. Nonetheless, Quality of Life (QoL) has become an important concept to evaluate effectiveness of treatment in mental health care research and disability studies. Given the almost exclusive focus on Health-related Quality of Life (HRQOL) in substance abuse research and the neglect of clients' perspectives in this field, we explore in this study the concept of QoL as perceived by drug users. Focus group discussions (n = 9) were organised in various treatment settings and community services for drug users in the region of Ghent, Belgium to identify important dimensions of QoL and their interpretation by drug users. Data were clustered and analysed based on the theoretical framework of Robert Schalock (Quality of life. Volume 1: Conceptualization and measurement, 1996). The domains 'personal relationships', 'social inclusion' and 'self-determination' were discussed most frequently by the participants. They stressed the importance of a supportive social network in particular. It can be concluded that QoL is not primarily associated by drug users with health and it involves much more than the aspects typically represented in measures of HRQOL.

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Section: Introductionmentioning

confidence: 99%

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

2008

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“…[12][13][14] Those who remain untreated or who are outside the social and health care system are known to experience higher rates of morbidity and mortality. [15][16][17] Given that abstinence-oriented therapies for opioid addiction have relatively low efficacy, 18 opioid agonist substitution is currently the most effective treatment option. 2 Oral methadone maintenance treatment (MMT) is the most common and accepted formulation and route of administration for substitution treatment.…”

Section: Introductionmentioning

confidence: 99%

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

et al. 2008

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Standardized assessment instruments such as the European Addiction Severity Index and the Maudsley Addiction Profile were employed. A total of 251 individuals were randomized from Vancouver, BC (192, 76.5%), and Montreal, Quebec (59, 23.5%); 38.5% were female, the mean age was 39.7 years (SD:8.6), and participants had injected drugs for 16.5 years (SD:9.9), on average. In the prior month, heroin was used a mean of 26.5 days (SD:7.4) and cocaine 16 days (SD;12.6). Vancouver had significantly more patients residing in unstable housing (88.5 vs. 22%; pG0.001) and higher use of smoked crack cocaine (16.9 days vs. 2.3 days in the prior month; pG0.001), while a significantly higher proportion of Montreal participants reported needle sharing in the prior 6 months (25% vs. 3.7%; pG0.001). In many respects, the patient cohort was similar to the European trials; however, NAOMI had a higher proportion of female participants and participants residing in unstable housing. This study suggests that the NAOMI study successfully recruited participants with a profile indicated for HAT. It also raises concern about the high levels of crack cocaine use and social marginalization.

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confidence: 87%

“…EuroQol, Health Utility Index, SF-6D, Quality of WellBeing, Assessment of Quality of Life). Recent evidence supports the construct validity of preference-weighted HRQL measures in SUD patients [2][3][4].There is a vigorous debate in the literature about the relative merits of subjective versus objective wellbeing for informing allocation of healthcare resources [5][6][7][8]. A major weakness cited for preference-weighted HRQL measures is that individuals assign preference weights to health states that they have not experienced, while a major weakness cited for life satisfaction measures is their strong association with personality traits, mood state, or both.…”

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confidence: 89%

Commentary on Dietze et al. (2010): Moving patient‐centered health outcomes forward

Pyne

2010

Addiction

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Commentary on Dietze et al. (2010): Moving patient-centered health outcomes forwarda dd_3210 2149..2150 In their paper in this issue of Addiction, Dietze et al. reported the life satisfaction of injecting drug users compared to the general population [1]. Life satisfaction was measured using the Personal Wellbeing Index (PWI), which has seven satisfaction domains: standard of living, health, achievements in life, personal relationships, personal safety, feeling a part of the community and future security. All PWI domains were significantly lower in the injecting drug users than the general population. They also showed that increasing injection frequency and recent serious mental health problems predicted lower life satisfaction and being employed predicted higher life satisfaction across all domains. The authors suggested that results from this measure could inform more tailored treatment approaches for substance use disorder patients.A variety of life satisfaction (or subjective wellbeing) and health-related quality of life (HRQL) measures are available. For clarity, I will focus on the PWI for life satisfaction and preference-weighted HRQL measures (e.g. EuroQol, Health Utility Index, SF-6D, Quality of WellBeing, Assessment of Quality of Life). Recent evidence supports the construct validity of preference-weighted HRQL measures in SUD patients [2][3][4].There is a vigorous debate in the literature about the relative merits of subjective versus objective wellbeing for informing allocation of healthcare resources [5][6][7][8]. A major weakness cited for preference-weighted HRQL measures is that individuals assign preference weights to health states that they have not experienced, while a major weakness cited for life satisfaction measures is their strong association with personality traits, mood state, or both. An implication for life satisfaction measures informing health-care resource allocation decisions, and being correlated strongly with mood state is a greater proportion of health-care resources being allocated for mental health services. As a psychiatrist, perhaps this is not a major weakness after all.Whose perspective to use for assigning value to quality of life is also part of the debate. For the PWI, this issue is straightforward: the patient answers the question about their own life satisfaction on a 0-10 scale. A method for assigning relative weights to various health and nonhealth factors affecting life satisfaction has been suggested [5]. Aside from including non-health factors as covariates and using a continuum of death to full life satisfaction instead of death to perfect health, the suggested method resembles the one used to develop preference weights for the Quality of Well-Being (QWB) measure [9].For HRQL measures, the general public is recommended typically as the source of preference weights because general public resources pay for health care, the general public is blind to self-interest and outcome valuations should be representative of the entire at-risk population. Interestingly,...

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High Abstinence Rates in Heroin Addicts by a New Comprehensive Treatment Approach

Cited by 35 publications

References 35 publications

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

Exploratory Study on Drug Users’ Perspectives on Quality of Life: More than Health-Related Quality of Life?

The North American Opiate Medication Initiative (NAOMI): Profile of Participants in North America’s First Trial of Heroin-Assisted Treatment

Commentary on Dietze et al. (2010): Moving patient‐centered health outcomes forward

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