Premature Discharge from Methadone Treatment: Patient Perspectives

Reisinger, Heather Schacht; Schwartz, Robert P.; Mitchell, Shannon Gwin; Peterson, James A.; Kelly, Sharon M.; O’Grady, Kevin E.; Marrari, Erica A.; Brown, Barry S.; Agar, Michael

doi:10.1080/02791072.2009.10400539

Cited by 89 publications

(97 citation statements)

References 33 publications

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“…Our findings indicated that some of our participants may have been unable to enter treatment while others may have simply wished to avoid the "hassles" of treatment (e.g., the need to go to the clinic daily for their medication, attend required counseling) (45) or would have preferred short-term detox if it had been available. (32) There have been long waiting lists in Baltimore (and elsewhere) for methadone treatment (2,3) for many years.…”

Section: Discussionmentioning

confidence: 95%

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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This study examined the uses of diverted methadone and buprenorphine among opiate-addicted individuals recruited from new admissions to methadone programs and from out-of-treatment individuals recruited from the streets. Self-report data regarding diversion were obtained from surveys and semi-structured qualitative interviews. Approximately 16% (n=84) of the total sample (N=515) reported using diverted (street) methadone 2-3 times per week for six months or more, and for an average of 7.8 days (SD=10.3) within the past month. The group reporting lifetime use of diverted methadone as compared to the group that did not report such use was less likely to use heroin and cocaine in the 30 days prior to admission (ps < .01) and had lower ASI Drug Composite scores (p < .05). Participants in our qualitative sub-sample (n=22) indicated that street methadone was more widely used than street buprenorphine and that both drugs were largely used as self-medication for detoxification and withdrawal symptoms. Participants reported using low dosages and no injection of either medication was reported.

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Section: Discussionmentioning

confidence: 95%

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

et al. 2009

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“…The reason for involuntary discharge was incarceration which was a common reason for dropout according to a previous study [58]. About one-third left MMT due to their desires in the DAMA group.…”

Section: Resultsmentioning

confidence: 99%

Can Heroin-Dependent Individuals Benefit from a Methadone Maintenance Treatment Program before They Drop Out against Medical Advice? A 12-Month Follow-Up Study

Wang

Wu²,

Lin³

et al. 2012

Eur Addict Res

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Aim: Little is known about whether heroin-dependent individuals receiving methadone maintenance treatment (MMT) who were discharged involuntarily and against medical advice (DAMA) get benefits before they left. The aims of this 12-month follow-up study were to examine whether the effects of MMT on depressive symptoms, heroin dependence and quality of life (QOL) are different among the non-DAMA group, the DAMA group, and the involuntarily discharged group, as well as the time effect of receiving MMT on changes in these three outcome indicators. Method: A total of 266 individuals receiving MMT were divided into the non-DAMA group, the DAMA group, and the involuntarily discharged group. Participants were interviewed at baseline and at 3, 6, 9, and 12 months of treatment for levels of depressive symptoms, heroin dependence and QOL. Results: The levels of depressive symptoms, heroin dependence and QOL in all three groups improved after receiving MMT for 3 months and the improvement was maintained during the MMT period. There were no significant differences in the three outcome indicators among the three groups. Conclusion: The results support the concept that heroin-dependent individuals benefit from MMT, even if they do not want to stay in the program or drop out involuntarily.

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“…The primary reasons for exiting treatment included incarceration and programme-related factors such as disagreeing with programme rules, conflict with staff and schedule conflicts [30]. Previous research in an Irish MMT setting has acknowledged the need for more research on the type of factors which contribute most to retention, treatment satisfaction and the reasons why patients take breaks from treatment [2,22].…”

Section: Introductionmentioning

confidence: 99%

Demographic and clinical factors predicting retention in methadone maintenance: results from an Irish cohort

Darker

Kelly

et al. 2015

Ir J Med Sci

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Background Retention in Methadone Maintenance Treatment (MMT) is superior to that of other therapies for opioid addiction, but with international retention rates around 50 % after 1 year of treatment, there remains a need for improved retention rates. Aims This study aimed to explore the demographic and clinical factors predicting retention in MMT. Methods Face-to-face surveys with MMT patients in a Dublin methadone clinic were conducted. Retention was assessed by the presence and duration of breaks in treatment at any stage. Results 189 patients participated in the study. 46 % (n = 87) reported having at least one break in treatment, and the median duration of a break was 3 months. Age, current methadone dose and prescription of antipsychotic medication were significant predictors of retention. Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment. Males tended to have significantly longer breaks. Patients reported that the main reasons for breaks were relapse into drug use (21.8 %, n = 19), incarceration (11.4 %, n = 10), weary of MMT (13.7 %, n = 12) or problems at the clinic (10.3 %, n = 9). Factors enabling regular attendance included wanting to get or stay clean (37.5 %, n = 51), avoidance of withdrawal symptoms (16.1 %, n = 22), methadone dependence (13.9 %, n = 19) and services provided (10.2 %, n = 14). Conclusion Patients who were older, single, living in their own home, on a higher dose of methadone, or taking antipsychotic medications had fewer breaks in treatment.

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Premature Discharge from Methadone Treatment: Patient Perspectives

Cited by 89 publications

References 33 publications

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

Uses of Diverted Methadone and Buprenorphine by Opioid‐Addicted Individuals in Baltimore, Maryland

Can Heroin-Dependent Individuals Benefit from a Methadone Maintenance Treatment Program before They Drop Out against Medical Advice? A 12-Month Follow-Up Study

Demographic and clinical factors predicting retention in methadone maintenance: results from an Irish cohort

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