Involving significant others in the care of opioid-dependent patients receiving methadone (original) (raw)
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Journal of Substance Abuse Treatment, 1997
The present study introduced a novel behavioral approach for encouraging methadonetreated patients to bring drug-free significant other support into treatment. Seventy-five patients referred to high-intensity psychosocial treatment due to chronic drug use were given 3 weeks to identify a drugfree significant other. Patients noncompliant with this intervention were started on a methadone dose taper that was stopped when significant other support was identified. Patients and their significant others were required to attend a significant other group one time per week for a minimum of 6 weeks. Eighty-five percent of the patients brought a drug-free significant other into treatment. Significant others included family members, partners, and friends. Patients who identified significant other support complied with 77% of their scheduled sessions. The results demonstrated that most methadone patients have drug-free support people who are willing to participate in their treatment. These individuals can be utilized to help patients initiate the process of building new drug-free social support networks.
Social support and abstinence from opiates and cocaine during opioid maintenance treatment
Drug and Alcohol Dependence, 2001
Social support may play an important role in helping drug users achieve abstinence; however these benefits may depend on the type of support experienced. In this prospective observational study, we examined the extent to which general and abstinence-specific support, both structural and functional, predicted opiate and cocaine abstinence in 128 opioid maintenance patients receiving either methadone or LAAM. A new multidimensional self-report instrument assessing abstinence-specific functional support was developed for the study. Previously validated measures were used to assess the remaining types of support. With baseline abstinence and other statistically important covariates adjusted, hierarchical logistic regression analyses demonstrated that the associations between social support at study baseline and biochemically confirmed abstinence 3 months later varied by type of support and by drug. Greater abstinence-specific structural support (operationalized as fewer drug users in the social network) and decreases in three types of negative abstinence-specific functional support (Complaints about Drug Use, Drug Exposure, and Demoralization) predicted cocaine, but not opiate abstinence. There were no effects for general support, whether structural or functional, on abstinence from either drug. Interventions that focus on modifying patients' abstinence-specific support may be helpful in reducing the high rates of cocaine use disorders in this population.
Shiraz E-Medical Journal, 2018
Background: Family plays a crucial role in improvement and treatment continuation of individuals under methadone treatment. Understanding, supporting, and accepting the patient by the family and friends are factors influencing the treatment and rehabilitation process. Objectives: The aim of this study was to determine the effect of family counseling on acceptance and support rates of patients under MMT. Methods: In this quasi-experimental study, 50 patients (25 in the intervention group and 25 in the control group) under methadone treatment, in addiction treatment centers, in Kermanshah were selected through cluster sampling and randomly divided into 2 intervention and control groups. Data collection from the patients in both groups was conducted before and 4 weeks after last session intervention using family support and acceptance questionnaires. Intervention for patients' family members (2 primary members for each patient) was held as a group-counseling meeting using Michael Free's methodology. Patients in the intervention and control group received only the usual care of the center. Data were entered into SPSS software (version 18) and analyzed using appropriate statistical tests. Results: The family social support rate for the patients before and 4 weeks after counseling in the control group changed from 165.14 ± 23.91 to 152.36 ± 17.66, indicating no significant difference. Additionally, this rate increased in the intervention group from 156.16 ± 22.88 to 167.6 ± 20.41, showing a significant difference. The rate of family acceptance of patients before and 4 weeks after counseling in the control group changed from 26.86 ± 4.94 to 26.30 ± 4.48, showing no significant difference. Furthermore, this rate in the intervention group increased from 26.93 ± 6.38 to 31.76 ± 3.72, indicating a significant difference. Conclusions: The results of the study showed that family counseling could increase the support rate for drug addicts and their acceptance by the family.
Social functioning and support of addicts on methadone
Open Medicine, 2013
The study aimed to determine characteristics of addicts on methadone maintenance therapy (MMT), which are related to the level of social functioning, with emphasis on the role of social support. In a prospective study, opiate addicts (n=150) who were on MMT completed the Pompidou questionnaire, the Social Adaptation Self-evaluation Scale (SASS) and the Multidimensional Scale of Perceived Social Support (MSPSS). Statistical data processing was based on testing the difference between features that best distinguish subgroups of addicts who were dissatisfied, moderately satisfied and satisfied with their social functioning. Opiate addicts up to 30 years of age had a statistically higher score on SASS scale than addicts over 30; addicts who are dissatisfied are mainly unemployed and have average or above-average family/community financial status; opiate addicts who were moderately satisfied with their social functioning were three years or longer on MMT; paradoxically, the highest mean v...
The role of social connection in opioid use disorder treatment engagement
Psychology of Addictive Behaviors
Objective: Medications for opioid use disorder (OUD or MOUD) treatment combining pharmacotherapy with psychosocial support are effective for managing OUD. However, treatment engagement remains a challenge, with retention rates ∼30%-50%. Although social connection has been identified as important to recovery, it remains unclear whether and how social factors can bolster participation in treatment. Method: Individuals receiving MOUD at three outpatient treatment programs (N = 82) and healthy community controls (N = 62) completed validated measures assessing social connection including (a) size, diversity, and embeddedness of social networks; (b) perceived social support and criticism within familial relationships; and (c) subjective social status. For those receiving MOUD, we also examined how aspects of social connection related to opioid (re)use and treatment engagement (medication adherence, group, and individual meeting attendance) assessed over ∼8 weeks/person. Results: Compared to controls, individuals receiving MOUD had smaller and less diverse and embedded social networks (Cohen's d > 0.4), and despite similar levels of perceived social support (d = 0.02), reported higher levels of social criticism (d = 0.6) and lower subjective social status (d = 0.5). Within the MOUD group, higher social network indices correlated specifically with higher therapeutic group attendance (Rs > 0.30), but not medication adherence, while higher levels of perceived criticism correlated with more frequent opioid use (R = 0.23). Results were mostly robust to control for sociodemographic variables, psychological distress/COVID-19, and treatment duration, but differed by MOUD type/program. Conclusions: These findings highlight the potential importance of assessing an individual's social capital, promoting positive social connection, and continuing to assess the implementation and value of psychosocial support in MOUD treatment. Public Health Significance Statement Individuals engaged in MOUD treatment report smaller and weaker social networks, perceive themselves as lower in social status, and experience higher levels of criticism. These factors may contribute to MOUD treatment engagement, particularly more "social" components like attending group meetings, as well as to reuse risk. Additional work is warranted to assess the implementation and value of psychosocial supports aimed at fostering social connection during MOUD treatment.
2019
Background Over the past 25 years, the United States has experienced an opioid epidemic that has cost hundreds of thousands of lives and which now constitutes as the worst drug overdose epidemic in U.S. history. Increases in opioid use and abuse have been found among men and women, most age groups, and all income levels (CDC, 2017). Methadone Maintenance Treatment (MMT) is one the most effective forms of treatment for opioid addiction, and has been found to reduce substance use, the risk of HIV, overdose, and criminal behaviors ( Joseph et al., 2000; Mattick, Breen, Kimber, & Davoli, 2009). Both clinical experience and research show that MMT programs suffer from low retention and patient engagement in treatment and that patients are particularly vulnerable to disengagement or withdrawal during the early stages of treatment (Baxter et al., 2013). To address this problem, Thomas Jefferson University Hospital Narcotic Addiction Rehabilitation Program (TJUH NARP) utilized funds from Gov...
Social relationships and intravenous drug use among methadone maintenance patients
Drug and Alcohol Dependence, 2001
This study examined the extent to which social relationships were associated with continued injection drug use and needle sharing among 252 methadone maintenance patients. Logistic regression analyses indicated that drug use was highest among persons who had a substance using live-in partner and among those with more drug-using social relationships. Among injectors, whites and those who had more people present during IV drug use were more likely to share needles, while those with more emotional support were less likely to do so. These findings suggest that personal relationships strongly influence continued injection drug use and that methadone programs should help patients develop social networks of non-users.
International Journal of Social Psychiatry, 2020
Background: Family interventions in substance use disorders (SUD) treatment is limited despite the evidence for benefits. Providing family interventions is hampered by patient resistance, social stigma, logistics and factors related to the capacity of the treatment programmes. Aims: The purpose of the study was to examine the association between family engagement in treatment, and opioid use defined by percentage negative opioid screen and rate retention in treatment defined by completion of study period. Methods: Data from a 16-week outpatient randomised controlled trial (RCT) of 141 adults with opioid use disorder (OUD) receiving Opioid Assisted Treatment (OAT) using buprenorphine/naloxone film (BUP/NX-F) was, used to examine the association between family engagement in and opioid use and rate of retention in treatment. Multiple logistic regression was, applied to examine the independent prediction of family engagement on opioid use and rate retention in treatment. Results: Family...
Opiate-Addicted Parents in Methadone Treatment: Long-Term Recovery, Health, and Family Relationships
Journal of Addictive Diseases, 2010
Few studies follow the lives of opiate-addicted parents. We examine a 12-year follow-up of 144 parents in methadone treatment and their 3-to 14-year-old children. Parent mortality was high. Among survivors, drug use and treatment, incarceration, residential and family disruptions, and health problems were common. Moderate and long-term recovery were associated with consistent methadone treatment, further education, employment, and fewer relationship disruptions. Earlier depression, deviant friends, and poor coping skills predicted continued drug problems. Thus, interventions should include treatment for depression and build skills for avoiding and refusing drugs, coping with stress, and maintaining recovery-supportive friendships.
Influences of family and friends on client progress during drug abuse treatment
Journal of substance abuse, 1996
Relationships with family and friends by 439 heroin addicts during the first 3 months of drug abuse treatment were examined in relation to behavioral improvements of clients. Family conflict and peer deviance were significant predictors of injection frequency and illegal activity during treatment, and reductions in family conflict were associated with lower drug use, injection frequency, and illegal activity during treatment. These results provide support for treatment emphasis on helping clients reduce conflict among family members, improve dysfunctional relationships with peers, and replace deviant friendships with others that encourage treatment participation and conformance to social norms.