Psychological Predictors of Retention in a Low-Threshold Methadone Maintenance Treatment for Opioid Addicts: A 1-Year Follow-Up Study

Abstract

This study investigated the role of psychological variables and judicial problems in treatment retention for a low-threshold methadone program in Montreal, Canada. Logistic regression analyses were computed to examine associations between psychological variables (psychological distress, self-esteem, stages of change), criminal justice involvement, and treatment retention for 106 highly-disorganized opioid users. Higher methadone dosage was associated with increased odds of treatment retention, whereas criminal charges and lower self-esteem decreased these odds. Psychological variables could be identified early in treatment and targeted to increase potential treatment retention. Financial support for this study was provided by the Fonds de Recherche en Santé du Québec.

Bidirectional relationships between retention and health-related quality of life in Chinese mainland patients receiving methadone maintenance treatment

“…Regarding the 2-year follow-up, patients with SF-36v2PCS scores > 49 (in both univariate and multivariate analyses) or SF-36v2MCS scores > 42 (in univariate analysis) had a lower risk of premature terminations than those with scores of ≤49 or ≤42, respectively, supporting our third hypothesis that better HRQoL predicts fewer treatment discontinuations; this result is consistent with the findings of a few previous studies [42,43], but contradicts the finding of another similar study that explored the HRQoL (measured by World Health Organization Quality of Life Assessment, Brief Version) on the basis of attendance rate among 105 self-funded heroin users and found that good social HRQoL was a predictor for poor methadone attendance [22]. This difference in our findings may result from the different characteristics of patients, study design, or analytical methods.…”

Retention of patients in opioid substitution treatment: A systematic review

“…Studies included in this review were conducted in 21 countries. The majority of studies were conducted in the United States of America (n = 25) [33, 34, 37, 39, 40, 47, 50, 54, 56, 58, 61, 62, 64, 68-72, 75, 79, 82, 84, 86, 88, 93], China (n = 14) [31, 36, 45, 57, 65-67, 80, 90, 92, 94-97], Canada (n = 9) [42,46,52,53,74,77,78,87,89] and Europe (n = 9) [32,38,41,43,48,51,55,59,73]. The remaining studies were spread across Asia (n = 5) [60,81,83,85,91], Israel (n = 3) [35,75,76], India (n = 1) [49], Australia (n = 1) [44] and Africa (n = 1) [63].…”

“…Mental health status was the most frequently assessed health factor, examined in 11 MMT cohorts [38,42,50,54,62,65,76,77,91,96], and five buprenorphine cohorts [58,69,72,86,93]. The factors studied varied from psychiatric diagnosis [38,69,72,76,86,93], to presence of symptoms or severity of psychiatric symptoms [50,54,62,65,77,91,96], psychiatric treatment history [42] and prescribed psychiatric medications [58]. Only one MMT study found significant effects, such that those with a DSM-IV Axis II diagnosis had reduced retention [76].…”

Vermont Hub-and-Spoke Model of Care for Opioid Use Disorder: Development, Implementation, and Impact

“…The lead author (J.B.) sketched together a set of variables that were important in determining the severity of need, loosely based on the Addiction Severity Index (ASI; McLellan et al, 2006). Further refinements based on clinical expertise and reviews of the scientific literature (eg, Sullivan et al, 2010; Bukten and Skurtveit, 2014; Fareed et al, 2014; Perrault et al, 2015) led to a brief 21-item screener. It assesses areas of psychosocial functioning (eg, legal, drug and alcohol use, transportation, chronic pain, social support) with individual items summed for a possible maximum score possible of 26 (Fig.…”