Recovery and Spiritual Transformation Among Peer Leaders of a Modified Methadone Anonymous Group

Glickman, Linda; Galanter, Marc; Dermatis, Helen; Dingle, Shannon

doi:10.1080/02791072.2006.10400592

Cited by 13 publications

(9 citation statements)

References 7 publications

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“…A void in the social life of individuals who discontinue compulsive drug or alcohol use is not limited to patients in methadone treatment programs and can be filled by attendance at 12 step meetings (Brown 1985). Unfortunately, patients enrolled in opioid agonist treatment are not always welcome in Narcotics Anonymous meetings and special groups called Methadone Anonymous have been developed to provide recovery support for patients in opioid agonist medications (Gilman et al, 2001; Glickman et al, 2006). …”

Section: Discussionmentioning

confidence: 99%

Why don’t out-of-treatment individuals enter methadone treatment programmes?

Peterson

Schwartz

Mitchell

et al. 2010

International Journal of Drug Policy

140

118

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Section: Discussionmentioning

confidence: 99%

Why don’t out-of-treatment individuals enter methadone treatment programmes?

Peterson

Schwartz

Mitchell

et al. 2010

International Journal of Drug Policy

140

118

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show abstract

“…While the stigma is undoubtedly created and reinforced by a number of historical and cultural factors, one potentially powerful source is the prevalence of an abstinence and morality-based discourse that currently dominates mainstream conceptions of drug treatment/addiction and is exemplified by 12-Step organizations such as Narcotics Anonymous (NA). According to this discourse, MMT is not a valid form of treatment, and MMT patients are active “addicts” who are socially stigmatized and typically excluded from mainstream 12-Step programs (Glickman et al 2006). …”

mentioning

confidence: 99%

The Trouble with Morality: The Effects of 12-Step Discourse on Addicts’ Decision-Making

Frank

2011

Journal of Psychoactive Drugs

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Since its development in the 1960s, researchers have extensively scrutinized methadone maintenance treatment (MMT) as a medical response to heroin addiction. Studies consistently find that MMT is more successful than other treatment models in the reduction of opiate/opioid misuse, the transmission of diseases like HIV/AIDS and hepatitis C, and criminal arrest and conviction rates. Nonetheless, a significant portion of active and former heroin addicts view MMT negatively and—perhaps as a result—MMT is vastly underused. This study examines the effects of 12-Step discourses on the opinions and treatment decisions of active heroin addicts, addicts in MMT, and addicts in 12-Step treatment programs. The study finds the abstinence/morality based discourse of drug addiction and treatment is pervasive among addicts and their non-drug using relations and peers alike; moreover, addicts have internalized this narrative, oftentimes despite their own knowledge of MMT’s success and positive personal experiences. The findings suggest that the dominance of abstinence/morality narratives contributes to MMT’s poor reputation among, and low use rate by current and former heroin addicts and that the power of the dominant discourse is such that it produces a desire to buy into its values and tenets even when it is against the individual’s interests to do so.

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“…In spite of the variability in the specific populations targeted, most interventions included individuals who were of low socio-economic status as indicated by education, low or under employment, housing status, and/or living on social security benefits (Coviello et al 2009 ; Aszalos et al 1999 ; Coviello et al 2004 ; Farabee et al 2002 ; Nurco et al 1995 ; Ronel et al 2011 ). In addition, many had been drug-involved for a number of years (Glickman et al 2006 ; Nurco et al 1995 ; Ronel et al 2011 ). This suggests that the results of this synthesis apply mainly to populations of low socio-economic status with a significant history of drug use (i.e., individuals who have used drugs such as cocaine and heroin for a long period of time).…”

Section: Resultsmentioning

confidence: 99%

Improving psychosocial health and employment outcomes for individuals receiving methadone treatment: a realist synthesis of what makes interventions work

et al. 2014

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BackgroundFor over 50 years, methadone has been prescribed to opioid-dependent individuals as a pharmacological approach for alleviating the symptoms of opioid withdrawal. However, individuals prescribed methadone sometimes require additional interventions (e.g., counseling) to further improve their health. This study undertook a realist synthesis of evaluations of interventions aimed at improving the psychosocial and employment outcomes of individuals on methadone treatment, to determine what interventions work (or not) and why.MethodsThe realist synthesis method was utilized because it uncovers the processes (or mechanisms) that lead to particular outcomes, and the contexts within which this occurs. A comprehensive search process resulted in 31 articles for review. Data were extracted from the articles, and placed in four templates to assist with analysis. Data analysis was an iterative process and involved comparing and contrasting data within and across each template, and cross checking with original articles to determine key patterns in the data.ResultsFor individuals on methadone, engagement with an intervention appears to be important for improved psychosocial and/or employment outcomes. The engagement process involves attendance at interventions as well as an investment in what is offered. Three intervention contexts (often in some combination) support the engagement process: a) client-centered contexts (or those where clients’ psychosocial and/or employment needs/issues/skills are recognized and/or addressed); b) contexts which address clients’ socio-economic conditions and needs; and, c) contexts where there are positive client-counselor and/or peer relationships. There is some evidence that sometimes ongoing engagement is necessary to maintain positive outcomes. There is also some evidence that complete abstinence from drugs (e.g., cocaine, heroin) is not necessary for engagement.ConclusionsIt is important to consider how the contexts of interventions might elicit and/or support clients’ engagement. Further research is needed to explore how an individual’s background (e.g., involvement with different interventions over an extended period) may influence engagement. Long-term engagement may be necessary to sustain some positive outcomes although how long is unclear and requires further research. Engagement can occur without complete abstinence from such drugs as cocaine or heroin, but additional research is required as engagement may be influenced by the extent and type of drug use.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-014-0026-3) contains supplementary material, which is available to authorized users.

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Recovery and Spiritual Transformation Among Peer Leaders of a Modified Methadone Anonymous Group

Cited by 13 publications

References 7 publications

Why don’t out-of-treatment individuals enter methadone treatment programmes?

Why don’t out-of-treatment individuals enter methadone treatment programmes?

The Trouble with Morality: The Effects of 12-Step Discourse on Addicts’ Decision-Making

Improving psychosocial health and employment outcomes for individuals receiving methadone treatment: a realist synthesis of what makes interventions work

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