Prediction of relapse to frequent heroin use and the role of methadone prescription: An analysis of the Amsterdam Cohort Study among drug users

Termorshuizen, Fabian; Krol, Anneke; Prins, Maria; Geskus, Ronald; Brink, Wim van den; Ameijden, E. J. C. Van

doi:10.1016/j.drugalcdep.2005.01.013

Cited by 96 publications

(87 citation statements)

References 37 publications

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“…There were no significant differences between the views of those currently injecting compared to those who were not currently injecting on their attitudes regarding the three ethical concerns about DCRs. The views of those no longer injecting are important since, as experienced past injectors, they can provide a particular perspective on how DCRs might have impacted on their own trajectory towards abstinence; moreover, longitudinal studies suggest that significant numbers of abstinent drug users will relapse to injecting drug use (Galai et al, 2003;Hser et al, 2001) including those receiving methadone treatment (Gossop 19 et al, 2003: Termorshuizen et al, 2005. A more recent consideration for those implementing new DCRs is the increase in the smoking of drugs (Hedrich et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

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Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Butler

Chapman

Terry

2016

Drugs: Education, Prevention and Policy

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Aims: The study investigated the attitudes of intravenous drug users (IDUs) towards the provision of drug consumption rooms (DCRs) in the UK and their willingness to use DCRs. Methods:Participants were 90 methadone-maintained outpatients recruited from a London clinic. A questionnaire asked about their willingness to use a DCR, their views on various rules commonly-implemented by DCRs, and how they believed DCRs might impact on the drug-taking behaviours of drug users and their peers. Findings: A large majority (89%) expressed willingness to use a DCR and accepted the need for rules such as no drug sharing (84.3%), no assistance with injecting (81.8%), compulsory supervision (76.7%) and compulsory hand washing (92.1%). However, the IDUs were split over whether injection in the neck or groin should be disallowed and whether certain categories of IDUs (e.g. juveniles, pregnant women) should be excluded from DCRs. Majorities thought it unlikely that DCRs would encourage users to try risker drug preparations (76.6%), or encourage non injectors to inject for the first time (74.5%). Conclusions: In a country where DCRs are not available, the study highlights the willingness of IDUs to use a DCR and accept its rules, even for a sample most of whom were not homeless.

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Section: Discussionmentioning

confidence: 99%

“…Intravenous administration is common amongst heroin users, for whom the profile of drug use is often long term and involves periods of abstinence and relapse (McLellan, 2000: Hser et al, 2001. Frequent relapse to injecting drug use also occurs during methadone maintenance treatment (Termorshuizen et al, 2005;Gossop et al, 2003).…”

Section: Introductionmentioning

confidence: 99%

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Butler

Chapman

Terry

2016

Drugs: Education, Prevention and Policy

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“…62,66 Cocaine use among opioid-dependent people has become a common practice. 67 While we have effective opioid addiction treatments, the lack of effective pharmacological approaches in the treatment of cocaine addiction jeopardizes opioid addiction treatment results, 23 given that the participants continue to be involved in criminal activities, health risk behaviors, and participate in the drug scene. Thus, cocaine use (in any form) among opioid-dependant people has become a significant problem for service providers.…”

Section: The North American Opiate Medication Initiative (Naomi)mentioning

confidence: 99%

“…1,20,21 Although MMT has been proven to be effective for some, it is well documented that a significant proportion of patients are not attracted into or do not respond to this therapy. 22,23 Many nonresponders relapse into the use of illicit street drugs and/or continue injecting illicit opiates even during methadone treatment. 24 For example, in British Columbia, only 52% of MMT patients are retained for at least a year 25 in line with estimates of retention found in the National Institute of Drug Abuse review, 26 but significantly lower than those observed in Ontario, 27 in a low-threshold program in Montreal, 28 and in most of the European countries.…”

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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“…Although its reported effectiveness varies across studies, methadone maintenance treatment is the most widely used form of OAT (2). Methadone's reported effectiveness for reducing illicit opioid use ranges between 20% and 70% (3)(4)(5). This large variation may be in part due to the inconsistent definitions and measurement of response to treatment.…”

Section: Introductionmentioning

confidence: 99%

The Genetics of Opioid Addiction Risk Evaluation Tool (GREAT) for Treatment Response in Methadone Patients

Dennis

Bawor

Paul

et al. 2016

Int J High Risk Behav Addict

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Background: Current tools such as the Maudsley Addiction Profile (MAP) exist to evaluate different facets of addiction severity, however these instruments have neither been designed for nor validated within patients on methadone maintenance treatment (MMT). Objectives: We aimed to provide a reliable tool to evaluate multiple domains of treatment response for patients on MMT. This tool can be applied easily with minimal time to patients, researchers and clinicians. Patients and Methods: We modified the MAP to address health and social outcomes specific to the MMT patient population. Construction of the new tool was accomplished using expert opinion and MAP scores from participants recruited for the Genetics of Opioid Addiction (GENOA) study. This modified scale known as the GENOA Risk Evaluation Tool (GREAT) was then applied to 21 MMT patients in a generalizability study (G-Study) to assess reliability and consistency. We performed a criterion validation of the GREAT to assess the predictive validity of GREAT substance use domain scores against urine toxicology screening for illicit opioids using multi-variable logistic regression analysis (n = 117).

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Prediction of relapse to frequent heroin use and the role of methadone prescription: An analysis of the Amsterdam Cohort Study among drug users

Cited by 96 publications

References 37 publications

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

Attitudes of intravenous drug users in London towards the provision of drug consumption rooms

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

The Genetics of Opioid Addiction Risk Evaluation Tool (GREAT) for Treatment Response in Methadone Patients

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