The Effectiveness of Group Family Training About the Principles of Harm Reduction Approach on Marital Satisfaction of Spouses of Patients Under Methadone Maintenance Treatment

Abstract

One of the most important problems in treatment of drug dependence is the cooperation of the patient's family. Many families do not look at drug dependence as a chronic and relapsing disorder and expect a quick and definite recovery of the disease. These families, including wives, are unfamiliar with the concept of harm reduction as a realistic approach. The aim of this study was to educate the spouses of patients undergoing methadone maintenance treatment (MMT) on the different aspects of harm reduction approach and assess the impact of this training on marital satisfaction and relapse rate. This study was a pretest-posttest study with control group. The sample consisted of 50 MMT patients and their wives in private methadone maintenance treatment clinics in the city of Bojnurd, located in the northeastern region of Iran. The experimental group received eight group training sessions run by a psychiatrist. The content of the training sessions was based on harm reduction programs for families of patients with high-risk behaviors. Two groups are compared in terms of marital satisfaction and relapse rate. A paired t test was used to compare changes before and after the training. The results of this study showed that harm reduction education and efforts for changing wives' views toward MMT are effective in increasing their marital satisfaction. However, the conducted training showed no effect on relapse rate in the six-month follow-up. Regarding the fact that this type of training has not been paid enough attention in the national protocol, the proposed training program of this research can be considered in MMT clinics.

The role of social network support on treatment outcomes for medication for opioid use disorder: a systematic review

“…More generally, many of the studies reviewed here reveal that characteristics of relationships, and not the particular types of relationships, may be the most influential aspects of social ties during treatment. For example, evidence from several studies across different time points suggests that, regardless of the type of relationship, having and maintaining social ties during treatment that are non-judgemental of MOUD or abstinence-positive [54, 77, 68, 60, 76, 63], that have little conflict [65, 64, 53], that are mutually non-substance-using [69, 43, 74, 78], or that involve cohabitation [61, 50, 56] is positively associated with successful treatment outcomes.…”

“…One experimental study randomly employed Behavioral Couples Therapy centered around partners practicing positive reinforcement of abstinence, finding that those in the couples therapy condition (N=19) had fewer positive urine screens during treatment than those in the individual therapy condition (N=17) [66]. Another study (N=47) cited improvements in retention and percentage opiate-free urine screens among a group receiving couples therapy [67], while the last study (N=48) which utilized a randomized intervention to educate spouses about the harm reduction approach found a significant improvement in marital satisfaction but no significant difference in retention at one month or six months [68].…”

“…Twenty-two studies reported drug use/abstinence as an MOUD outcome. Ten were experimental [65,66,67,68,69,70,71,59,60,72] and 12 were observational [34,33,55,35,36,37,56,38,39,40,41,32]. Sixteen studies indicated that social network support was related with reduced drug use/abstinence [67,68,69,33,55,35,36,72,37,41,56,70,59,38,71,39].…”

“…Thirteen of 16 studies exploring family social network support within the drug use/abstinence outcome demonstrated significant improvements in treatment retention/adherence [67,68,69,33,55,35,36,37,56,70,38,71,39] and three had no significant change [34,65,66]. Improvements in outcome were indicated in five experimental studies [67,68,69,70,71] and eight observational studies [33,55,35,36,37,56,38,39].…”

A Psychodynamic Study on Wives of Males Addicted to Opium

“…The unmet psychoemotional, economic, and social needs of mothers in such families may threaten their mental and emotional health (13). In fact, addiction affects all intimate relationships of the addict (14).…”