Patterns of adherence to oral methadone: Implications for prescribers

Haskew, Michael E.; Wolff, Kim; Dunn, John

doi:10.1016/j.jsat.2007.08.013

Cited by 27 publications

(19 citation statements)

References 27 publications

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“…Findings support previous work indicating that supervised consumption can promote adherence to prescribed methadone use [72]. The high frequency of pick-ups reported should also mean that individuals do not have large quantities to pass on at any one time, unless they are stockpiling, and should help to guarantee adherence to treatment [72]. …”

Section: Discussionsupporting

confidence: 83%

The nature of methadone diversion in England: a Merseyside case study

Duffy

Baldwin

2012

Harm Reduction Journal

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BackgroundMethadone maintenance treatment (MMT) is a key element in treatment for opiate addiction; however concerns about the diversion of methadone remain. More current empirical data on methadone diversion are required. This research investigated the market for diverted methadone in Merseyside, UK, in order to provide a case study which can be transferred to other areas undertaking methadone maintenance treatment on a large scale.MethodsQuestionnaires were completed (in interview format) with 886 past year users of methadone recruited both in and out of prescribing agencies. Topic areas covered included current prescribing, obtaining and providing methadone, reasons for using illicit methadone and other drug use.ResultsLarge proportions of participants had obtained illicit methadone for use in the past year with smaller proportions doing so in the past month. Proportions of participants buying and being given methadone were similar. Exchange of methadone primarily took place between friends and associates, with 'dealers' rarely involved. Gender, age, whether participant's methadone consumption was supervised and whether the aims of their treatment had been explained to them fully, influenced the extent to which participants were involved in diverting or using diverted methadone.ConclusionMethadone diversion is widespread although drug users generally do not make use of illicit methadone regularly (every month). The degree of altruism involved in the exchange of methadone does not negate the potential role of this action in overdose or the possibility of criminal justice action against individuals. Treatment agencies need to emphasise these risks whilst ensuring that treatment aims are effectively shared with clients to ensure adherence to treatment.

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Section: Discussionsupporting

confidence: 83%

The nature of methadone diversion in England: a Merseyside case study

Duffy

Baldwin

2012

Harm Reduction Journal

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“…The mean duration of methadone treatment was 7.6 years (SD = 4.4). A high proportion of the sample (86.5%) followed at least two methadone treatment episodes, which is not surprising given the high drop-out rates in substitution treatment [51]. …”

Section: Methodsmentioning

confidence: 99%

Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment

et al. 2010

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PurposeThis study explores the current QoL of opiate-dependent individuals who started outpatient methadone treatment at least 5 years ago and assesses the influence of demographic, psychosocial, drug and health-related variables on individuals’ QoL.MethodsParticipants (n = 159) were interviewed about their current QoL, psychological distress and severity of drug-related problems, using the Lancashire Quality of Life Profile, the Brief Symptom Inventory and the Addiction Severity Index. Potential determinants of QoL were assessed in a multiple linear regression analysis.ResultsFive years after the start of methadone treatment, opiate-dependent individuals report low QoL scores on various domains. No association was found between drug-related variables and QoL, but a significant negative impact of psychological distress was identified. Severity of psychological distress, taking medication for psychological problems and the inability to change one’s living situation were associated with lower QoL. Having at least one good friend and a structured daily activity had a significant, positive impact on QoL.ConclusionsOpiate-dependent individuals’ QoL is mainly determined by their psychological well-being and a number of psychosocial variables. These findings highlight the importance of a holistic approach to treatment and support in methadone maintenance treatment, which goes beyond fixing the negative physical consequences of opiate dependence.

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“…The study conducted in London to explore the pattern of non-adherence shares similar results: a small majority of the current clients were "adherent" to the treatment (58%), 24% of them were "partially adherent" and 18% of them were of "poor adherence" [9]. In the study of Haskew, the level of adherence was categorised into three scenarios: "poor adherence" means that clients had consumed 1-2 methadone doses per month, "partial adherence" was the group of clients who consumed 3-28 doses of methadone per month, and "adherence" means that client who were consumed 29-30 doses of methadone per month.…”

Section: Individual Factorsmentioning

confidence: 73%

Factors determining dropping out from treatment among methadone clients: a qualitative study in Can Tho City, Vietnam

Hong¹,

Prisca²,

Ho³

et al. 2017

HIV & AIDS Review

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Introduction: Methadone maintenance therapy (MMT) is a multiple therapy used for opiate dependence. It is combined with psychological therapies that aim at supporting individuals, families, and communities in improving their health, reducing criminal activities, and minimising risky behaviours for human immunodeficiency virus (HIV) transmission. Retention in treatment is associated with a successful outcome of MMT. Material and methods:Provided since 2008 in Vietnam, MMT has been implemented in Can Tho province since 2010. However, its dropout rate is high: nearly 40% from 2010 to 2015. Evidence is insufficient to understand the factors that influence the drop out rates among MMT patients in Vietnam, and more especially in Can Tho province. There is an urgent need to better understand the reasons and the context in which MMT dropouts occur, in order to inform the development of policies and programmes that can improve adherence to MMT in Can Tho.Results: Qualitative interviews have been conducted with 17 methadone clients (dropouts and current), 4 health workers and 3 family members of clients. Barriers to retention in treatment included individual factors, community factors and institutional factors. Conclusions:The factors influencing the decision to drop out among MMT clients could be at individual, community, or institutional levels. This study suggests that increasing meaningful involvement of the clients' families and strengthening counselling sessions on adherence for clients can improve their retention in treatment and thus the MMT outcomes.

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Patterns of adherence to oral methadone: Implications for prescribers

Cited by 27 publications

References 27 publications

The nature of methadone diversion in England: a Merseyside case study

The nature of methadone diversion in England: a Merseyside case study

Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment

Factors determining dropping out from treatment among methadone clients: a qualitative study in Can Tho City, Vietnam

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