Methadone Maintenance Treatment Versus Methadone Maintenance Treatment Plus Auricular Acupuncture: Impacts on Patient Satisfaction and Coping Mechanism.

J Pharm Pract. 2013 Jun 13;
Lua PL, Talib NS, Ismail Z

This study intended to (1) describe the baseline patient satisfaction level and preferred coping strategies and (2) assess patient satisfaction and coping mechanisms pre- and postintervention. Patients on methadone maintenance treatment (MMT) in Terengganu, Malaysia, were randomized into either MMT or MMT plus auricular acupuncture (MMT + AA) groups. All received the standard MMT, while participants on MMT + AA underwent concurrent AA session thrice weekly for 2 months (each session = 30 minutes). Data analysis was carried out using SPSS 16.0, employing descriptive and nonparametric statistics. Participations were received from 97 eligible male patients (median age = 36.0 years; Malay = 97.9%). After screening for dropouts, only 69 patients were considered for subsequent analysis (MMT = 40; MMT + AA = 29). At preintervention, both groups did not differ significantly in the parameters investigated. During postintervention, no significant difference was detected for satisfaction level but coping-wise, substance use was significantly and frequently adopted by MMT + AA patients compared to MMT respondents (P < .05). On separate analysis, those who received MMT alone adopted active coping, venting, and self-blame significantly more frequently postintervention (P < .05). Nevertheless, no significant difference for coping styles of MMT + AA patients was exhibited over time (P >.05). The addition of AA therapy into the standard MMT treatment did not seem to influence patient satisfaction and their coping ways.
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Efforts to Reduce Overdose Deaths.

Am J Public Health. 2013 Jun 13;
Sherman SG, Han J, Welsh C, Chaulk P, Serio-Chapman C

The recent article by Schwartz et al. addresses the intersection of two important public health issues: opiate substitution therapy and fatal heroin overdose.(1) In the United States, drug overdose is responsible for more than 36?000 deaths annually(2) and is the leading cause of death among illicit drug users. Baltimore, Maryland, has one of the highest per capita heroin addiction rates in the nation, with an estimated prevalence of heroin use in 10% of the population.(3) Schwartz et al. conducted a 15-year ecological analysis in Baltimore and found that increases in buprenorphine and methadone treatment with concurrent decreases in overdose deaths, controlling for heroin purity. Along with previous research,(4) this study demonstrates the far-reaching benefits of opiate agonist treatment. (Am J Public Health. Published online ahead of print June 13, 2013: e1. doi:10.2105/AJPH.2013.301410).
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Schwartz et al. Respond.

Am J Public Health. 2013 Jun 13;
Schwartz RP, Gryczynski J, O’Grady KE, Sharfstein JM, Warren G, Olsen YK, Mitchell SG, Jaffe JH

As reported in our recent article, which found an association between expansion of methadone and buprenorphine treatment and the reduction in heroin overdose deaths in Baltimore, Maryland, between 1995 and 2009, the distribution of the opioid antagonist naloxone is one of a number of public health strategies being employed in the United States and United Kingdom (among other countries) to reduce opioid overdose deaths.(1-4) From 2004 through 2009, the office of the Baltimore City Health Commissioner led an overdose prevention education and naloxone distribution (OPEND) program (J.?M.?S served as the Health Commissioner during part of that period). The OPEND program was initially funded by a foundation’s Drug Addiction Treatment Program (led by R.?P.?S.), and was inspired by the Chicago Recovery Alliance’s pioneering overdose prevention program. The program taught drug-addicted individuals and their significant others to identify the symptoms of overdose, to call 911, to provide rescue breathing, and, if available, to inject naloxone while waiting for an ambulance. (Am J Public Health. Published online ahead of print June 13, 2013: e1. doi:10.2105/AJPH.2013.301428).
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