Factors associated with early and later dropout from methadone maintenance treatment in specialist addiction clinics: a six-year cohort study using proportional hazards frailty models for recurrent treatment episodes

Durand, Louise; Boland, Fiona; O'Driscoll, Denis; Bennett, Kathleen; Barry, Joseph; Keenan, Eamon; Fahey, Tom; Cousins, Gráinne

doi:10.1016/j.drugalcdep.2020.108466

Cited by 24 publications

(14 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Benzodiazepine use was found to be common among MMT clients [28]. Furthermore, the benzodiazepine use is also a strong predictor for the drop out of the methadone clients within 12 months [29]. Use of benzodiazepine identified by urine in this study was associated with higher ASI scores for family (p = 0.0209), low dose methadone clients (p = 0.014) and clients who had longer MMT duration (p = 0.031).…”

Section: Discussionmentioning

confidence: 54%

Factors affecting addiction severity index (ASI) among clients enrolled in methadone maintenance treatment (MMT) program in Myanmar

2021

View full text Add to dashboard Cite

Background Opioid substitution with methadone maintenance treatment (MMT) is shown to reduce illicit opioid use and renew social functioning. Understanding factors that undermine clients’ social functioning during MMT treatment is vital for improving treatment compliance and quality of life. Method A total of 210 respondents who were already enrolled in a formal MMT program in Myanmar were recruited from five cities through stratified random sampling for this cross-sectional study. The addiction severity index (ASI) was used to objectively assess respondents social functioning in the last 30 days. Higher ASI scores denote poorer social functioning. Result Respondents total ASI scores in the respective domains were: employment (47.4%), alcohol (44.4%), drug use (7.2%), legal (49.2%) and social–family relationship (10.7%). Those reported to have never injected drugs in the last 30 days had lower ASI total scores than those who reported injection drug use (p = 0.01). After identifying the differences in ASI total scores, we found there were significant associations in the clients’ hepatitis C status, age category, frequency of heroin injection, quality of life score, marital status, current leisure status with family/friend, current history of injection in the last 30 days, income status, satisfaction with current marital status, as well as reported drug and alcohol use (p < 0.05). Stepwise binary logistic regression showed that alcohol and higher frequency of heroin injection were associated with higher ASI scores. Meanwhile, older age, respondents those who had leisure time with family, and satisfied with current marital status had lower ASI scores (p < 0.05). Conclusion Our results indicate that those enrolled in the MMT program in Myanmar faced many challenges in their daily social functioning. Treatment providers must take heed of these apparent impediment to ensure clients chequered social functioning does not undermine their treatment compliance. Trial registration: NA

show abstract

Section: Discussionmentioning

confidence: 54%

Factors affecting addiction severity index (ASI) among clients enrolled in methadone maintenance treatment (MMT) program in Myanmar

2021

View full text Add to dashboard Cite

show abstract

“…Secondly, despite our efforts to have a broad representation of both male and female service users, only 29% of service users recruited to the expert panel were women, and there was no representation of non-binary identities. Although we had a lower representation of women in treatment, this reflects the gender profile of people in OAT in Ireland, as approximately 32% of people in treatment are women ( Cousins et al, 2017 ; Durand et al, 2021 ). Thirdly, we focused on OAT and did not address broader issues such as polydrug use, homelessness or dual diagnoses.…”

Section: Discussionmentioning

confidence: 91%

Consensus recommendations for opioid agonist treatment following the introduction of emergency clinical guidelines in Ireland during the COVID-19 pandemic: A national Delphi study

Durand

Keenan

Boland

et al. 2022

International Journal of Drug Policy

Self Cite

View full text Add to dashboard Cite

“…Therefore, high-risk sexual behaviors are related to a greater probability of relapse. In addition, short continuous treatment days indicate poor adherence because of which relapse is always a dominant cause ( 18 , 56 ). Our findings are consistent with the aforementioned conclusions, and we, therefore, suggest implementing health education for preventing HIV/STI and anti-narcotics in the whole process of treatment to promote adherence and reduce the relapse rate.…”

Section: Discussionmentioning

confidence: 99%

The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

Tang

Fan

Wang

et al. 2023

Front. Public Health

View full text Add to dashboard Cite

BackgroundRelapse is a great barrier to improving the effectiveness of methadone maintenance treatment (MMT). Participants with different treatment durations could vary in their compliance with MMT, which may lead to different levels of relapse risk. This study aims to identify the risk factors for relapse and assess the relapse risk of MMT participants of different treatment durations.MethodThis retrospective study used data collected from seven MMT clinics in Guangdong Province, China, from January 2010 to April 2017. Newly enrolled participants who received 6 (n = 903) and 12 (n = 710) months of consecutive treatment with complete data were included. We selected significant risk factors for relapse through the group lasso regression and then incorporated them into Bayesian networks to reveal relationships between factors and predict the relapse risk.ResultsThe results showed that participants who received 6-month treatment had a lower relapse rate (32.0%) than those of 12-month treatment (39.0%, P < 0.05). Factors including personal living status and daily methadone dose were only influential to those who received the 6-month treatment. However, age, age at the initial drug use, HIV infection status, sexual behaviors, and continuous treatment days were common factors of both durations. The highest relapse risk for those after the 6-month treatment was inferred as 66.7% while that of the 12-month treatment was 83.3%. Farmers and those who have high accessibility to MMT services may require additional attention.ConclusionIt is necessary to implement targeted interventions and education based on the treatment durations of participants to decrease the relapse rate. Meanwhile, those about HIV/sexually transmitted infection prevention and anti-narcotics should be held in the whole process.

show abstract

Factors associated with early and later dropout from methadone maintenance treatment in specialist addiction clinics: a six-year cohort study using proportional hazards frailty models for recurrent treatment episodes

Cited by 24 publications

References 34 publications

Factors affecting addiction severity index (ASI) among clients enrolled in methadone maintenance treatment (MMT) program in Myanmar

Factors affecting addiction severity index (ASI) among clients enrolled in methadone maintenance treatment (MMT) program in Myanmar

Consensus recommendations for opioid agonist treatment following the introduction of emergency clinical guidelines in Ireland during the COVID-19 pandemic: A national Delphi study

The risk assessment of relapse among newly enrolled participants in methadone maintenance treatment: A group-LASSO based Bayesian network study

Contact Info

Product

Resources

About