Posts Tagged ‘methadone maintenance treatment’

Policy implementation of methadone maintenance treatment and HIV infection … – 7thSpace Interactive (press release)

Policy implementation of methadone maintenance treatment and HIV infection … 7thSpace Interactive (press release) To view methadone maintenance treatment (MMT) globally, it is necessary to accumulate data on MMT policy implementation under different health service systems. The aim of the current study is to provide empirical evidence about policy implementation of …

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Effectiveness and feasibility study of routine HIV rapid testing in an urban methadone maintenance treatment program.

Am J Drug Alcohol Abuse. 2013 Jul; 39(4): 247-251
Seewald R, Bruce RD, Elam R, Tio R, Lorenz S, Friedmann P, Rabin D, Garger YB, Bonilla V, Perlman DC

Abstract Background: Universal Human Immunodeficiency Virus (HIV) testing and treatment are strategies to decrease AIDS-related morbidity and mortality and to reduce HIV transmission. Objective: This study examined the feasibility and effectiveness of routine HIV rapid testing implemented in the largest New York City (NYC) Methadone Maintenance Treatment Program (MMTP). Methods: A routine HIV rapid testing program performed by medical providers without pretest counseling or the provision of incentives was compared to HIV rapid testing done by referral to HIV counselors with pretest counseling and incentives over the prior 12 months. Results: Routine HIV rapid testing proved feasible and effective when performed by the medical staff in the setting of a large urban MMTP. The program increased HIV testing in all genders, race/ethnicities, and ages. HIV-positive individuals were diagnosed and successfully linked to care. The elimination of HIV prevention counseling may have facilitated expanded testing. Conclusion: This study confirms that routine HIV rapid testing without HIV-prevention counseling or the provision of incentives for patients is feasible on a large scale in a busy, urban methadone clinic.
HubMed – Methadone

Effectiveness of prize-based contingency management in a methadone maintenance program in China.

Drug Alcohol Depend. 2013 Jul 4;
Chen W, Hong Y, Zou X, McLaughlin MM, Xia Y, Ling L

Methadone maintenance treatment (MMT) has been successfully scaled up nationally in China. However, the program faces problems of poor attendance and high rates of continued drug use. We assessed whether a contingency management (CM) intervention implemented by MMT clinic staff could improve treatment attendance and drug abstinence.Eight MMT clinics in Guangdong province were randomly selected and divided into two groups. A total of 126 participants (55 in urban clinics and 71 in rural clinics) received CM during a 12-week trial, 120 participants (83 in urban clinics and 37 in rural clinics) received usual treatment (UT). Participants in the CM group had the opportunity to draw for prizes contingent on attending treatment daily and testing negative for morphine. Clinic- and individual-level outcomes were compared between the intervention and control groups.The retention rate and negative urine testing rate were 14.2% (P=0.010) and 10.7% (P<0.001) higher in the CM group compared to the UT group, respectively. Compared with participants who received UT, CM participants missed on average 7.3 fewer (P=0.008) visits and were 1.91 (95% CI: 1.53-2.39) times more likely to submit a negative urine sample. All clinic- and individual- level effects of the intervention were observed at rural clinics, but the difference in retention rate between urban CM and UT clinics was not significant.Although the frequency of monitoring and value of the incentives in this study was lower than in previous studies, the CM intervention significantly improved attendance and reduced drug use in China. HubMed – Methadone

“Try not to judge”: mothers of substance exposed infants.

MCN Am J Matern Child Nurs. 2013 Jul-Aug; 38(4): 200-5
Cleveland LM, Gill SL

To describe the hospital experiences of mothers who give birth to substance-exposed infants.Secondary analysis of data from a larger study that was focused on the experiences of Mexican-American mothers in the neonatal intensive care unit (NICU) was conducted. Semistructured interviews with five women who were recovering addicts on methadone were analyzed. Each of their infants spent time in an NICU following birth. The transcribed interviews were analyzed using qualitative content analysis.Four themes were identified: (a) “try not to judge,” (b) “scoring” the baby, (c) “share with me,” and (d) “I’m the mother here!”The quality of the relationship between the mothers and the nurses in the NICU was a crucial aspect of the mothers’ experiences and may have an effect on long-term outcomes. Women with addictions often have other significant risk factors that may further jeopardize their ability to mother; therefore, it is essential to develop a strong support network. Nurses can be instrumental in organizing resources for this population of women. Judging behaviors may have a detrimental effect on women with addictions. Maternal adaptation to the mothering role can be enhanced by making reasonable efforts to include the mother in the care of the infant.
HubMed – Methadone

Psychopathology and pain correlates of dispositional optimism in methadone-maintained patients.

Am J Addict. 2012 Nov; 21 Suppl 1: S56-62
Beitel M, Savant JD, Cutter CJ, Peters S, Belisle N, Barry DT

Background and Objectives: Although higher levels of dispositional optimism are associated with decreased levels of psychopathology and pain, and higher levels of mental health functioning-important outcomes in opioid treatment programs-a paucity of studies has examined dispositional optimism among individuals with opioid use disorders. The aim of this study was to examine the clinical correlates (ie, psychopathology, pain status) of dispositional optimism in opioid dependent patients enrolled in methadone maintenance treatment (MMT). Methods: A survey targeting demographics, pain, psychopathology, and dispositional optimism was administered to 150 MMT patients. Results: In multivariable analyses, higher levels of dispositional optimism were significantly associated with lower levels of: depression, screened personality disorder criteria, screened symptoms of posttraumatic stress disorder, and pain-related emotional strain. In comparison to those without a history of chronic pain (ie, noncancer related physical pain lasting at least 3 months), MMT patients who reported either lifetime or current chronic pain exhibited significantly lower levels of dispositional optimism. Conclusions and Scientific Significance: The associations among higher levels of dispositional optimism, lower levels of psychopathology, and lower pain-related emotional strain suggest that research focusing on the efficacy of specific interventions to promote dispositional optimism in MMT patients is warranted. (Am J Addict 2012;21:S56-S62).
HubMed – Methadone

Meaning and Methadone: Patient Perceptions of Methadone Dose and a Model to Promote Adherence to Maintenance Treatment.

J Addict Med. 2013 Jun 25;
Sanders JJ, Roose RJ, Lubrano MC, Lucan SC