Attendance at Counseling Sessions Predicts Good Treatment Response in Methadone Maintenance Therapy (original) (raw)
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Significant problems of global and inexpensive problems are significant spikes in Asia, including Indonesia are symptoms of narcotics, alcohol, psychotropic, and other active substances and HIV/AIDS transmission. The number of drug use in Indonesia continues to increase until 2008 reached 3.6 million people [1]. Opiate addicts commonly use heroin, and most use unsafe injections, both in terms of equipment that tends to be used repeatedly and alternately, as well as injection sites on the body that are not generally cleaned first. As a result, it is very easy to get infections such as bone, joint, endocarditis, sepsis, soft-tissue, and tetanus infections, as well as other blood-transmitted viruses such as Hepatitis (B, C, and D) and HIV [2]. Mortality rates of heroin use in the range of 1-2% per year due to overdose, drug-induced disease, and death from violence [3]. Premature deaths due to criminal problems to support heroin use habits, dose ambiguity, purity, and even heroin identity are used [4]. To reduce the adverse effects of opiate use by injection, harm reduction is required. One approach to harm reduction is a maintenance therapy program by providing metadona in liquid preparations, known as metadona Maintenance Therapy Program (PTRM) [2]. PTRM is already proven to help reduce opiate dependence. Unfortunately, there is a new problem that disrupts the success of this program, the drop out (DO) of methadone therapy that will result in the patient's desire to return again to consume heroin. In addition, patients will return at risk of contracting HIV and AIDS diseases. According to the 2006 Research conducted by Huissod et al. [9] and Bao et al., [10] showed an influence between doses with retention of methadone therapy patients. Research Liu et al. [6] and Dilla et al. also showed an effect between doses with patient retention in methadone therapy [11]. Research in hospital drug addiction Jakarta related to retention predictors for 1 year or more in various variables, i.e. age, methadone dose, sex, education, residence, occupation, and marital status. It was found that dosage and age were predictors of 1 year or more of retention in methadone maintenance therapy (MMT) [2]. Based on the problem, this research is intended to examine the effect between dose and retention and has never been done in RSUP H. Adam Malik Medan. METHODS Research design The data were collected prospectively for patients who participated in the MMT program at Adam Malik General Hospital in Medan. The data
Health, 2015
Drug addiction is one of the current world's hygienic, mental and social problems. There are different treatments for this illness. MMT (Methadone Maintenance Therapy) is considered as a standard and acceptable therapy for addiction; and there are many affecting factors regarding gaining success in this type of treatment. In this study, we investigated some of these factors. One of the most important issues in MMT is to keep up patient on his/her treatment till complete abstinence; therefore, it is recommended that the patient does not leave his/her therapy without discretion of the therapist. In this study, 230 patients, who began MMT, and admitted to addiction treatment centers of Yazd province were included. In this study, the survival rate in the first, third, and sixth months were evaluated as 93.9%, 63.48%, and 28.36%, respectively. It was found that following parameters are important in rate of survival during treatment: family support, gender, dose of methadone and concomitant use of morphine during treatment. Moreover, factors like level of education, marital status, age and concomitant use of methamphetamine during treatment * Corresponding author.
Predictive factors for treatment retention in methadone programs in Indonesia
Journal of Substance Abuse Treatment
This article presents the results of a 6-month prospective cohort study of methadone maintenance treatment (MMT) in Indonesia. The study aimed to investigate the predictor variables of retention in MMT in Indonesia. The duration of treatment (in days) was the main outcome of the study. For the study, program, client, social network, and accessibility factors were investigated as potential predictors of retention. The study analyzed the relative weight of each factor in predicting treatment retention. The sample consisted of 178 clients drawn from three participating clinics: Rumah Sakit Ketergantungan Obat and Tanjung Priok in Jakarta and Sanglah in Bali. The 3-and 6-month retention rates were 74.2% and 61.3%, respectively. These rates are comparable with previous studies conducted in developed countries. A survival analysis using a robust estimation for the Cox PH regression found that the strongest predictors of retention were methadone dose followed by an interaction between take-home dose and the experience of the clinic providing this treatment. Other significant predictor variables included age, perceived clinic accessibility, and client's belief in the program. The study concludes that MMT cannot solely rely on the pharmacology for retention but should also promote informed access to take-home doses.
Journal of Psychiatrists' Association of Nepal, 2019
Introduction: Methadone maintenance treatment program is one of the accepted form of treatment modalities for opioid dependence individuals in Nepal. Retention in the treatment represents the assessment of the effectiveness of the treatment program. The aim of this study was to find out the factors associated with the retention of clients in the Methadone maintenance clinics in the Kathmandu Valley. Material and Method: A total of 84 clients were recruited from the 5 different methadone clinics of Kathmandu valley. A prospective follow-up design was used. The patients were followed up at the end of 6 months and retention rate was calculated. The patient was considered ‘drop out “if the patient did not take methadone for 7 consecutive days. Group differences between ‘dropout’ and non-dropout (retained) clients on MMT program were tested using t-test and Chi-square test for continuous variables and categorical variables respectively. Results: At the end of 6 months 63 patients still ...
Predictors of retention in methadone maintenance therapy: A prospective multi-center study
Scientific Research …, 2010
In the methadone maintenance therapy (MMT) as the treatment of choice in opiate dependency, retention is considered as a target. Given the paucity of data regarding factors affecting retention in MMT in Iran, we sought to determine the predictors of duration of retention. This multi-center prospective study was conducted at 7 outpatient treatment facilities in 4 cities in Iran, in 2007. 282 consecutive opiate dependent people were followed for 6 months, following their entry to MMT. Independent data were registered at baseline and included socio-demographic, social, psychological, drug related and legal data. Length of retention in MMT (0-6) considered as dependent variable. Predictors of length of retention were determined using a backward linear regression model. Retention was 0 months in 17.7% (n = 50), 1 months in 19.8% (n = 56), 2 months in 9.2% (n = 26), 3 months in 3.5% (n = 10), 4 months in 8.2% (n = 23), 5 months in 18.8% (n = 53) and 6 months in 22.7% (n = 64). According to the backward linear regression, the only predictors of remission were city (B=0.427, p < 0.001, CI = 0.339-0.514), perceived importance of distance to clinic (B =-0.008, p = 0.085, CI =-0.018-0.001), perceived social support (B = 0.006, p= 0.069, CI = 0.000-0.013), and perceived pleasure with drug use (B = 0.010, p = 0.007, CI = 0.003-0.017). This study shed light on factors that may serve as barriers for remaining in MMT for opiate dependence, in Iran. Some variables should be considered in programs developed by Iranian authorities to increase retention rate in MMT.
Describing the Programme on Methadone Maintenance Therapy in Selangor, Malaysia
Global Journal of Health Science, 2020
INTRODUCTION: Drug addiction and drug abuse is a serious public health problem worldwide. Millions of people worldwide suffered from drug use disorders, directly and indirectly, attributable to drug use and included deaths related to HIV and hepatitis C acquired through unsafe injecting practices. Many parts of the world have a shortfall in prevention and treatment for drug use disorders, with only less than 10% of people with drug use disorders receiving treatment yearly. Medication-assisted treatment of opioid dependence like Methadone is used in maintenance therapy or detoxification helps people with drug use disorders. MATERIAL AND METHODS: Secondary data from an existing electronic dataset in Ministry of Health (MOH) from 2015 until 2019, which includes registered patients who had undergone Methadone Maintenance Therapy (MMT) either government or private facilities were included. The dataset divided into few domains namely socio-demographic, treatment modalities, clinic locatio...
Harm Reduction Journal, 2010
Background: Methadone is a synthetic opiate mu receptor agonist that is widely used to substitute for illicit opiates in the management of opiate dependence. It helps prevent opiate users from injecting and sharing needles which are vehicles for the spread of HIV and other blood borne viruses. This study has the objective of determining the utility of daily methadone dose to predict retention rates and re-injecting behaviour among opiate dependents. Methods: Subjects comprised opiate dependent individuals who met study criteria. They took methadone based on the Malaysian guidelines and were monitored according to the study protocols. At six months, data was collected for analyses. The sensitivity and specificity daily methadone doses to predict retention rates and reinjecting behaviour were evaluated.
Determinants of successful methadone maintenance treatments in two groups of patients: a first study
Italian Journal of Public Health, 2012
Background: drug abuse is a social and public health problem, with high costs to society. It is, therefore, important to develop effective treatments for this problem, and evaluate these by identifying determinants of successful outcomes in order to plan more efficient public health interventions. The methadone maintenance treatment (MMT), at an appropriate dosage, is recognized as the most effective therapy for opiate addiction, but it is very important to consider the motivation and stage of change of patients for reaching treatment success. These must also be considered when investigating the determinants of MMT success. The aim of this study is to identify the determinants of successful MMT given to "heroin-addicts" attending the drug addiction Services of the Local Health unit of the Italian autonomous Province of Trento in two groups of patients, as outlined below. MeTHodS: a retrospective cohort study was conducted. 393 heroin addicted patients, admitted for the first time to a MMT program in the drug addiction Services of Trento Local Health unit between the years 2000-2008, were considered. Patients were divided into 2 groups on the basis of the objective of treatment suggested by the clinical team and negotiated with the patient: group a labelled high evolution, group B low evolution. High evolution corresponds to a clinical situation in which, by opinion of the operators, the patient has the ability to pursue goals of change. In these cases, the methadone treatment is aimed at reaching a drug free condition and the goal/outcome is opioid abstinence (negative urine results in 90%-100%). Low evolution is characterized by little or no compliance to the assessment and/or therapeutic proposal aimed at achieving change. In these cases, the methadone treatment is aimed at achieving two or more of the following objectives: retention in treatment regimens, improvement of health and/or psychological distress, reduction of criminal activity, of overdose risk, of risk behavior and increase of work. The probability of successful treatment was estimated by means of a multivariate logistic model. The odds ratios and 95% confidence intervals were calculated. reSuLTS: for group a, the absence of previous admissions into rehabilitation centres, and social therapy associated with MMT were associated to an overall successful treatment. For the group B, the determinants of successful MMT were: having started treatment after 35 years, having a low educational level, not having previous imprisonments and not assuming the substance more than once a week. concLuSIonS: the "program" related factors usually considered (like for instance: previous admissions into rehabilitation centres, social therapy) and "individual" ones (like for instance: having started treatment after 35 years, having a low educational level, not having previous imprisonments and not assuming the substance more than once a week), influenced the effectiveness of MMT in a different way: if for patients in high evolution group the determinants of success were more associated to "program-related" factors, in the case of the low evolution group, the positive outcome seemed to be mostly related to "individual" factors.