Dropout from Interim Methadone and Subsequent Comprehensive Methadone Maintenance

Gryczysnki, Jan; Schwartz, Robert P.; O’Grady, Kevin E.; Jaffe, Jerome H.

doi:10.3109/00952990903322865

Cited by 13 publications

(11 citation statements)

References 23 publications

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“…Others may prefer short-term treatment because they are highly motivated to cease their drug use and desire to be abstinent from all opioids, including medications. Some studies support motivation as a prospective correlate of retention (Booth, Corsi, & Mikulich-Gillbertson, 2004; Simpson & Joe, 1993), while others have not found this relationship (Gryczynski et al, 2012; Gryczynski, Schwartz, O’Grady, & Jaffe, 2009). Unfortunately, the parent study did not include instruments measuring patient motivation.…”

Section: Discussionmentioning

confidence: 99%

Leaving buprenorphine treatment: Patients' reasons for cessation of care

Gryczynski

Mitchell

Jaffe

et al. 2014

Journal of Substance Abuse Treatment

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Many opioid-dependent patients leave treatment prematurely. This study is a planned secondary analysis from a randomized trial of counseling for African Americans (N=297) entering buprenorphine treatment at one of two outpatient programs. This study examines: (1) whether patients’ initial treatment duration intentions prospectively predict retention; and (2) patients’ reasons for leaving treatment. Participants were queried about their treatment duration intentions at treatment entry, and their reasons for leaving treatment at 6-month follow-up. At baseline, 28.0% reported wanting to stay in buprenorphine treatment less than 6 months, while 42.1% actually left buprenorphine treatment within 6 months. However, participants intending short-term buprenorphine at the outset were not at elevated risk of early treatment discontinuation (OR=1.15; p=.65). Participants attributed treatment cessation predominantly to conflicts with staff, involuntary discharge, and perceived inflexibility of the program. Future research should examine patient-centered models of buprenorphine treatment that could improve retention.

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Section: Discussionmentioning

confidence: 99%

Leaving buprenorphine treatment: Patients' reasons for cessation of care

Gryczynski

Mitchell

Jaffe

et al. 2014

Journal of Substance Abuse Treatment

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“…Gender has not consistently predicted entry or retention 1,29–31 , although there is some evidence to suggest that men are more likely to be retained 28,32 . While some studies have found treatment readiness for cessation of drug use to be an important influence on retention 11 in different treatment modalities (e.g., long term residential, outpatient, methadone) 20,25,33,34 , others have not found this relationship 35,36 , particularly among samples of African-American patients 35,37 . Similarly, poor mental health may worsen retention in buprenorphine treatment in some studies 38 , while other studies have suggested a link between depressive symptomatology and retention 47,48 .…”

Section: Introductionmentioning

confidence: 98%

Hospitalized opioid‐dependent patients: Exploring predictors of buprenorphine treatment entry and retention after discharge

et al. 2017

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Objectives Few studies have explored predictors of entry into and retention in buprenorphine treatment following linkage from an acute medical hospitalization. Methods This secondary analysis of a completed clinical trial focuses on medically hospitalized, opioid dependent patients (n=72) who were randomized to an intervention including buprenorphine induction and dose stabilization during hospitalization followed by post-discharge transition to office-based buprenorphine treatment (OBOT)). Predictors included demographics, days hospitalized, prior buprenorphine/methadone treatment, PTSD symptoms, social support, and readiness for drug use cessation. Outcome variables were treatment entry and retention (number of days in OBOT). Results Previous buprenorphine treatment, more days hospitalized, and higher PTSD symptoms predicted OBOT entry. Prior treatment, older age, and non-minority status were associated with a higher mean number of days in OBOT. Conclusions OBOT may appeal to patients who have tried buprenorphine in other settings. Linking hospitalized patients to OBOT may improve utilization of addiction treatment. Scientific Significance: Prior substance treatment, longer hospital stay, and mental health should be examined in future linkage studies.

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“…Patient treatment motivation at intake in patients with drug dependence was also associated with the formation of better therapeutic relationships, more favorable perceptions of counselor competence, support from peers, and increases in session attendance Broome, Simpson, and Joe 1999;Meier et al 2005). However, other studies found no association between pretreatment motivation and treatment engagement, subjective reasons for drop-out, or with treatment outcomes in patients in methadone maintenance programs (Gryczynski et al 2009a(Gryczynski et al , 2009b.…”

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confidence: 98%

Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders

Oene

Góngora

Sternberg³

et al. 2015

Journal of Psychoactive Drugs

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The aims of this study were to examine the relationship between motivation for treatment and for change, and to explore their role in the prediction of treatment completion. The sample was composed of 560 predominantly polydrug-using inpatients with co-occurring psychiatric disorders. Motivation for treatment was assessed with the Motivation for Treatment Scales, and motivation for change was measured with the Readiness to Change Questionnaire. Patients indicated strong motivation to change illegal drug and alcohol use. In initial factor analysis, motivation for treatment and for change did not load on the same factors, confirming that these are distinct domains. Four categories were discerned with respect to readiness for treatment and for change, with low agreement between the two. In performing survival analysis, we found that being in readiness category 4 (RT↑RC↑) was associated with a greater chance of remaining in treatment for a period of 105 days without premature attrition (Log Rank chi-sq=5.000; p=0.02). To a limited extent, intake measures of motivation can be used to predict attrition from treatment. Clinicians can use motivation assessment both for clinical purposes and in the prediction of those who need extra monitoring due to increased risk of premature attrition.

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Dropout from Interim Methadone and Subsequent Comprehensive Methadone Maintenance

Cited by 13 publications

References 23 publications

Leaving buprenorphine treatment: Patients' reasons for cessation of care

Leaving buprenorphine treatment: Patients' reasons for cessation of care

Hospitalized opioid‐dependent patients: Exploring predictors of buprenorphine treatment entry and retention after discharge

Motivation for Treatment and Motivation for Change in Substance-Dependent Patients with Co-Occurring Psychiatric Disorders

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