Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification

Amato, Laura; Davoli, Marina; Vecchi, Simona; Ferri, Marica; Mayet, Soraya

doi:10.1002/14651858.cd005031.pub2

Cited by 53 publications

(60 citation statements)

References 62 publications

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“…Taken overall, the findings from the present study reflect factors that have consistently been shown to be associated with client outcomes during OST (Amato et al . 2004; Caplehorn et al .…”

Section: Discussionsupporting

confidence: 86%

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Clients' perceptions of opioid substitution treatment: An input to improving the quality of treatment

Deering

Horn

Frampton

2012

Int J Mental Health Nurs

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Despite the emphasis on providing high quality mental health and addiction treatment, there has been relatively little consideration given to examining clients' perceptions of addiction treatment (consumer satisfaction) as a quality improvement strategy. The present article reports on a survey of a representative sample of 93 clients receiving opioid substitution treatment (OST). Employed participants reported higher treatment satisfaction and a pattern of positive associations was found between satisfaction and general health, mental health, social functioning, lower methadone doses, and participants' ratings of their treatment progress. Lower satisfaction was associated with higher frequency of benzodiazepine use, and, for women, longer treatment duration. Māori participants rated their treatment progress as lower than that of non-Māori. Results strongly endorse recording participants' comments to provide a deeper understanding of survey item ratings. The study findings highlight the need for a research focus on the roles of mental health and other registered nurses who work with people receiving OST in specialist service and primary care settings, and endorse a partnership approach to future research in this area. The pattern of findings arising from this study suggests key strategies for improving the flexibility and client responsiveness of OST.

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Section: Discussionsupporting

confidence: 86%

“…1998). In addition, the inclusion of psychosocial support has been shown to decrease illicit opioid use during treatment (Amato et al . 2004).…”

Section: Introductionmentioning

confidence: 99%

Clients' perceptions of opioid substitution treatment: An input to improving the quality of treatment

Deering

Horn

Frampton

2012

Int J Mental Health Nurs

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“…Although the intervention was only a small‐scale pilot that ran until the IOT clinic closed, RE methodology enabled detailed and nuanced insights into the contexts and mechanisms that facilitated and constrained its implementation and outcomes in the real world of changing policy, practice and funding. Findings complement existing international literature on CM with opiate users on substitution treatments , but cannot be generalized empirically. Nonetheless, themes evident in the data have potential transferability to other CM‐related interventions for people with complex drug problems and are likely to be relevant to the general design and implementation of CM in clinical settings.…”

Section: Discussionmentioning

confidence: 66%

“…Randomized controlled trials and systematic reviews have demonstrated the effectiveness of CM when provided alongside other addiction therapies. Positive outcomes include reduced drug use , abstinence , better treatment retention and improved attendance at appointments There is also evidence that CM can significantly increase adherence to, and completion of, hepatitis B vaccination programmes among people who inject and those receiving opioid substitution therapy .…”

Section: Introductionmentioning

confidence: 99%

Qualitative evaluation of a novel contingency management‐related intervention for patients receiving supervised injectable opioid treatment

2015

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“…methadone, naltrexone) to rid the body of opioids while decreasing withdrawal‐related discomfort . The goal of detoxification is not treatment per se but, rather, controlled reduction of opioid dependence . Detoxification (i.e.…”

Section: Introductionmentioning

confidence: 99%

Mortality among individuals accessing pharmacological treatment for opioid dependence in California, 2006–10

et al. 2015

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Aims To estimate mortality rates among treated opioid-dependent individuals by cause and in relation to the general population, and to estimate the instantaneous effects of opioid detoxification and maintenance treatment (MMT) on the hazard of all-cause and cause-specific mortality. Design Population-based treatment cohort study. Setting Linked mortality data on all individuals first enrolled in publicly-funded pharmacological treatment for opioid dependence in California, USA from 2006 to 2010. Participants 32,322 individuals, among whom there were 1,031 deaths (3.2%) over a median follow-up of 2.6 years (interquartile range: 1.4 - 3.7). Measurements The primary outcome was mortality, indicated by time to death, crude mortality rates (CMR), and standardized mortality ratios (SMR). Findings Individuals being treated for opioid dependence had a more than four-fold increase of mortality risk compared with the general population (SMR 4.5 95% CI: 4.2, 4.8). Mortality risk was higher (1) when individuals were out-of-treatment (SMR 6.1, 95% CI: 5.7, 6.5) than in-treatment (SMR 1.8, 95% CI: 1.6, 2.1) and (2) during detoxification (SMR 2.4, 95% CI 1.5, 3.8) than during MMT (SMR 1.8, 95% CI 1.5, 2.1), especially in the two weeks post-treatment entry (SMR 5.5, 95% CI 2.7, 9.8 versus SMR 2.5, 95% CI 1.7, 4.9). Detoxification and MMT both independently reduced the instantaneous hazard of all-cause and drug-related mortality. MMT preceded by detoxification was associated with lower all-cause and other-cause-specific mortality than MMT alone. Conclusions In people with opiate dependence, detoxification and methadone maintenance treatment both independently reduce the instantaneous hazard of all-cause and drug-related mortality.

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Psychosocial and pharmacological treatments versus pharmacological treatments for opioid detoxification

Cited by 53 publications

References 62 publications

Clients' perceptions of opioid substitution treatment: An input to improving the quality of treatment

Clients' perceptions of opioid substitution treatment: An input to improving the quality of treatment

Qualitative evaluation of a novel contingency management‐related intervention for patients receiving supervised injectable opioid treatment

Mortality among individuals accessing pharmacological treatment for opioid dependence in California, 2006–10

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