Determinants of Successful Treatment Outcomes Among a Sample of Urban American Indians/Alaska Natives: The Role of Social Environments.
Determinants of Successful Treatment Outcomes Among a Sample of Urban American Indians/Alaska Natives: the Role of Social Environments.
J Behav Health Serv Res. 2013 Mar 13;
Spear SE, Crevecoeur-Macphail D, Denering L, Dickerson D, Brecht ML
Very few studies have analyzed the role of social environments on substance abuse treatment outcomes among urban American Indians/Alaska Natives (AI/ANs). This study examined a measure of positive treatment response-abstinence from substance use at treatment discharge-among urban AI/ANs in Los Angeles County. The sample included all AI/ANs in outpatient drug-free (e.g., no methadone) treatment and residential treatment from 2004 to 2008 (N?=?811). Predictors of abstinence at discharge were (a) having recovery-oriented social support and (b) not having a difficult living situation (i.e., experiencing family conflict and/or living with someone who uses alcohol and/or drugs). Higher levels of recovery-oriented social support in the past 30 days predicted abstinence during outpatient treatment. In residential treatment, retention of 90 days or more, high recovery-oriented social support, and not experiencing difficult living situations predicted abstinence. Suggestions for optimizing treatment outcomes among AI/ANs and areas of further research are provided.
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A Preliminary Study Comparing Methadone and Buprenorphine in Patients with Chronic Pain and Coexistent Opioid Addiction.
J Addict Dis. 2013 Jan; 32(1): 68-78
Neumann AM, Blondell RD, Jaanimägi U, Giambrone AK, Homish GG, Lozano JR, Kowalik U, Azadfard M
Patients with opioid addiction who receive prescription opioids for treatment of nonmalignant chronic pain present a therapeutic challenge. Fifty-four participants with chronic pain and opioid addiction were randomized to receive methadone or buprenorphine/naloxone. At the 6-month follow-up examination, 26 (48.1%) participants who remained in the study noted a 12.75% reduction in pain (P = 0.043), and no participants in the methadone group compared to 5 in the buprenorphine group reported illicit opioid use (P = 0.039). Other differences between the two conditions were not found. Long-term, low-dose methadone or buprenorphine/naloxone treatment produced analgesia in participants with chronic pain and opioid addiction.
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Hypertension, chronic obstructive pulmonary disease, diabetes and depression among older methadone maintenance patients in British Columbia.
Drug Alcohol Rev. 2013 Mar 11;
Maruyama A, Macdonald S, Borycki E, Zhao J
INTRODUCTION AND AIMS: Risk factors in older methadone maintenance treatment (MMT) patients may put them at a greater risk of acquiring chronic diseases; however, this group might experience barriers to treatment resulting in reduced recommended prescriptions. The research objective for this study was to assess whether MMT patients were significantly different from a matched control group in terms of medications dispensed for hypertension, chronic obstructive pulmonary disease (COPD), diabetes and depression. DESIGN AND METHODS: The research design was a case-control study, where prescription claims data from the British Columbia database were used. MMT patients 50 years of age and older were randomly selected, and control subjects were individually matched in terms of age, sex, social assistance coverage and geographic jurisdiction. RESULTS: Each group consisted of 199 participants. Odds ratios (OR) were calculated to compare the odds of MMT patients to non-MMT patients on a first-line medication for each chronic disease under investigation. The MMT group was significantly more likely to receive medications for COPD (OR?=?32.68, P?HubMed – Methadone
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