nach oben

International Journal of Mental Health and Addiction

Erschienen in:

01.06.2014

A Qualitative Study of Prescribing Doctor Experiences of Methadone Maintenance Treatment

verfasst von: Marie Claire Van Hout, Tim Bingham

Erschienen in: International Journal of Mental Health and Addiction | Ausgabe 3/2014

Einloggen, um Zugang zu erhalten

Abstract

Methadone maintenance treatment [MMT] is recognized as an effective treatment for opiate dependence. It is provided in Ireland in addiction clinics and for stabilized patients in primary care. The aim of the study was to explore doctor’s experiences of methadone prescribing, therapeutic alliance and methadone treatment pathways. Semi structured interviews were conducted with a convenience sample of prescribing doctors (n = 16). Thematic analysis of narratives was undertaken. Observations around MMT were positive in reducing harm associated with injecting drug use and opiate dependence, and represented an important turning point for patients. Doctor efforts to assist their patients were grounded in positive, empathic relationships. Some concerns were relayed with regard to prescribing restrictions. Participants commented on the need for policy makers to consider the expansion of MMT provision to include alternative pharmacological approaches, improved interagency, psychosocial and detoxification supports, community based nurse prescribing and adjunct treatment for poly drug and alcohol use.

Abouvanni, G., Stevens, L. J., Harris, M. F., Wickes, W., Ramakrishna, S. S., Ta, E., et al. (2000). GP attitudes to managing drug- and alcohol-dependent patients: a reluctant role’. Drug and Alcohol Review, 19, 165–170.CrossRef

Amato, L., Davoli, M., Perucci, C. A., Ferri, M., Faggiano, F., & Mattick, R. P. (2005). An overview of systematic reviews of the effectiveness of opiate maintenance therapies: available evidence to inform clinical practice and research. Journal of Substance Abuse Treatment, 28, 321–329.PubMedCrossRef

Appel, R. W., Ellison, A. A., Hadley, K. J., & Oldak, R. (2004). Barriers to enrollment in drug abuse treatment and suggestions for reducing them: stakeholders. The American Journal of Drug and Alcohol Abuse, 30(129), 153.

Ball, J. A., & Ross, A. (1991). The effectiveness of methadone maintenance treatment. New York: Springer.CrossRef

Bell, J., Burrell, T., Indig, D., & Gilmour, S. (2006). Cycling in and out of treatment: Participation in methadone treatment in NSW, 1990–2002. Drug and Alcohol Dependence, 81, 55–61.

Bennett, T., & Wright, R. (1986). Opioid users’ attitudes towards and use of NHS clinics, general practitioners and private doctors. British Journal of Addiction, 81, 757–763.PubMedCrossRef

Bobrova, N., Rhodes, T., Power, R., Alcorn, R., Neifeld, E., & Krasiukov, N. (2006). Barriers to accessing drug treatment in Russia: a qualitative study among injecting drug users in two cities. Drug and Alcohol Dependence, 82, S57–S63.PubMedCrossRef

Bobrova, N., Alcorn, R., Rhodes, T., Rughnikov, I., Neifeld, E., & Power, R. (2007). Injection drug users’ perceptions of drug treatment services and attitudes toward substitution therapy: a qualitative study in three Russian cities. Journal of Substance Abuse Treatment, 33, 373–378.PubMedCrossRef

Broekaert, E., & Van der Plasschen, W. (2003). Towards the integration of treatment systems for substance abusers: report on the second international symposium on substance abuse treatment and special target groups. Journal of Psychoactive Drugs, 35, 237–245.PubMedCrossRef

Butler, S. (2002). The making of the methadone protocol: the Irish system? Drugs: Education, Prevention and Policy, 9, 311–324.

Caplehorn, J. R., Irwig, L., & Saunders, J. B. (1996). Physicians’ attitudes and retention of patients in their methadone maintenance programs. Substance Use & Misuse, 31, 663–677.CrossRef

Caplehorn, J. R., Lumley, T. S., & Irwig, L. (1998). Staff attitudes and retention of patients in methadone maintenance programs. Drug and Alcohol Dependence, 52, 57–61.PubMedCrossRef

Carnwath, T., Peacock, J., Huxley, P., Davies, A., & Bowers, L. (1999). Are all districts equally ready for “shared care” of drug misusers? Addiction Research, 6, 307–318.CrossRef

Corsi, K., Lehman, W. K., & Booth, R. E. (2009). The effect of methadone maintenance on positive outcomes for opiate injection drug users. Journal of Substance Abuse Treatment, 37, 120–126.PubMedCentralPubMedCrossRef

Coviello, D. M., Zanis, D. A., Wesnoski, S. A., Lynch, K. G., & Drapkin, M. (2011). Characteristics and 9-month outcomes of discharged methadone maintenance clients. Journal of Substance Abuse Treatment, 40, 165–174.PubMedCentralPubMedCrossRef

De Maeyer, J., Van der Plasschen, W., Camfield, L., Van Huele, S., Sabbe, B., & Broekaert, E. (2011). A good quality of life under the influence of methadone: a qualitative study among opiate-dependent individuals. International Journal of Nursing Studies, 48, 1244–1257.PubMedCrossRef

Delargy, I. (2008). Survey of general practitioners participating in the methadone treatment programme. Dublin: Irish College of General Practitioners.

Dennis M., Scott CK., Funk R., & Foss M., (2005). The duration and correlates of addiction and treatment careers. Journal of Substance Abuse Treatment, 28, 51–62

Dole, V. P., & Nyswander, M. E. (1980). Methadone maintenance: A theoretical perspective. In D. J. Lettieri, M., Sayers, & H. W. Pearson (Eds.), Theories on drug abuse: Selected contemporary perspectives (pp. 256–261). NIDA Research Monograph 30. Washington, DC: U. S. Government Printing Office. Available from: http://archives.drugabuse.gov/pdf/monographs/download30.html (Accessed 12 December 2011).

Farrell, M., & Barry, J. (2010). The introduction of the Opioid Treatment Protocol. Dublin: Health Service Executive. Available from: www.drugsandalcohol.ie/14458 (Accessed 14 December 2011).

Ford, C., & Ryrie, I. (2010). A comprehensive package of support to facilitate the treatment of problem drug users in primary care: an evaluation of the training component. The International Journal on Drug Policy, 11, 387–392.CrossRef

Friedman, S. R., Tempalski, B., Perlis, T., Keem, M., Friedman, R., & Flom, P. (2004). Estimating numbers of injecting drugs users in metropolitan areas for structural analyses of community vulnerability and for assessing relative degrees of service provision for injection drug users. Journal of Urban Health, 81, 377–400.PubMedCentralPubMedCrossRef

Gabbay, M., Smith, S., & Dawkes, M. (1996). A study of drug misusers’ contacts with general practitioners. Addiction Research and Theory, 4, 125–137.CrossRef

Gabbay, M. B., Clarke, S., Willert, E., & Esmail, A. (1999). Shared care methadone clinics a survey of patient satisfaction, behaviour change and staff views. Addiction Research, 7, 129–147.CrossRef

Gabbay, M., Shiels, C., & vanden Bos, A. (2001). Turning the tide’: influencing future GP attitudes to opiate misusers. Education for General Practice, 12, 144–152.

Gerra, G., Ferri, M., Polidori, E., Santoro, G., Zaimovic, A., & Sternieri, E. (2003). Long-term methadone maintenance effectiveness: psychosocial and pharmacological variables. Journal of Substance Abuse Treatment, 25, 1–8.PubMedCrossRef

Gjersing, L., Waal, H., Caplehorn, J.R.M., Gossop, M., & Clausen, T., et al. (2010). Staff attitudes and the associations with treatment organisation, clinical practices and outcomes in opioid maintenance treatment, BMC Health Services Research, 10, 194.

Gossop, M., Marsden, J., Stewart, D., & Treacy, S. (2001). Outcomes after methadone maintenance and methadone reduction treatments: two-year follow up results from the National Treatment Outcome Research Study. Drug and Alcohol Dependence, 62, 255–264.PubMedCrossRef

Gowing, L. R., Ali, R. L., & White, J. M. (2000a). The management of opioid withdrawal. Drug and Alcohol Review, 19, 309–318.CrossRef

Gowing, L. R., Ali, R. L., & White, J. M. (2000b). Buprenorphine for the management of opioid withdrawal. The Cochrane Library, 8, 3.

Gowing, L. R., Farrell, M., Bornemann, R., Sullivan, L. E., & Ali, R. L. (2006). Brief report: methadone treatment of injecting opioid users for prevention of HIV infection. Journal of General Internal Medicine, 21, 193–195.PubMedCentralPubMedCrossRef

Grella, C. E., Karno M. P., Warda U. S., Moore A. A., Niv N. (2009). Perceptions of need and help received for substance dependence in a national probability survey. Psychiatric Services, 60, 1068–1074.

Gruer, L., Wilson, P., Scott, R., Elliott, L., Macleod, J., Harden, K., et al. (1997). General practitioner centred scheme for treatment of opiate dependent drug injectors In Glasgow. British Medical Journal, 314, 1730–1735.PubMedCentralPubMedCrossRef

Harris, J., & McElrath, K. (2012). Methadone as Social Control: Institutionalized Stigma and the Prospect of Recovery. Qualitative Health Research. January, 9th 2012, Early Online.

Health Service Executive (2011). The introduction of the opioid treatment protocol. Dublin. Available from: www.drugs.ie/pdfs/2010/Opioid_Treatment_Protocol.pdf (Accessed 12 December 2011).

Holt, M. (2007). Agency and dependency within treatment: drug treatment clients negotiating methadone and antidepressants. Social Science & Medicine, 64, 1937–1947.CrossRef

Hopkins, A., & Clark, D. (2005). Using heroin, trying to stop, and accessing treatment: A qualitative analysis of the experiences and vies of clients on the Peterborough Nene Drug Interventions Programme, unpublished.

Ison, J., Day, E., Fisher, K., Pratt, M., Hull, M., & Copello, A. (2006). Self-detoxification from opioid drugs. Journal of Substance Use, 11, 81–88.CrossRef

Järvinen, M. (2008). Approaches to methadone treatment: harm reduction in theory and practice. Sociology of Health & Illness, 30, 975–991.CrossRef

Joseph, H., Stancliff, S., & Langrod, J. (2000). Methadone maintenance treatment (MMT): a review of historical and clinical issues. The Mount Sinai Journal of Medicine, 67, 347–364.

Kapadia, N., Fox, D., Rowlands, G., & Ashworth, M. (2007). Developing primary care services for high-dose benzodiazepine-dependent patients: a consultation survey. Drugs: Education, Prevention and Policy, 14, 429–442.

Kelly, J. F., & Westerhoff, C. M. (2010). Does it matter how we refer to individuals with substance-related conditions? A randomized study of two commonly used terms. The International Journal on Drug Policy, 21, 202–207.PubMedCrossRef

Leaver, E., Elford, J., Morris, J. K., & Cohen, J. (1992). Use of general practice by intravenous heroin users on a methadone programme. British Journal of General Practice, 42, 465–468.PubMedCentralPubMed

Lloyd, C. (2010). Sinning and sinned against: The stigmatisation of problem drug users. York: University of York.

Luoma, J. B., Twohig, M. P., Waltz, T., Hayes, S. C., Roget, N., Padilla, M., et al. (2007). An investigation of stigma in individuals receiving treatment for substance abuse. Addictive Behaviours, 32, 1331–1346.CrossRef

Luty, J., & Grewal, P. (2002). A survey of the British public’s attitudes towards drug dependence. Journal of Substance Use, 7, 93–95.CrossRef

Matheson, C., Pitcairn, J., Bond, C. M., van Teijlingen, E., & Ryan, M. (2003). General practice management of illicit drug users in Scotland: a national survey. Addiction, 98, 119–126.PubMedCrossRef

Mattick, R. P., Ali, R., & Lintzeris, N. (Eds.). (2009). Pharmacotherapies for the treatment of opioid dependence: Efficacy, cost-effectiveness, and implementation guidelines. New York: Informa Healthcare.

McDonnell, A., & Van Hout, M. (2010). Maze and minefield: a grounded theory of opiate self detoxification in rural Ireland. Drugs and Alcohol Today, 10, 24–31.CrossRef

McDonnell, A., & Van Hout, M. (2011). Heroin detoxification-seeking, a grounded theory of process and practicalities. The Grounded Theory Review, 10, 17–14.

McKeganey, N. (2005). Abstinence and harm reduction: two roads to one destination? Drugs Education Prevention and Policy, 12, 251–253.CrossRef

McKeganey, N., Morris, Z., Neale, J., & Robertson, M. (2004). What are drug users looking for when they contact drug services: abstinence or harm reduction. Drugs: Education, Prevention and Policy, 11, 423–435.

McKeown, A., Matheson, C., & Bond, C. (2003). A qualitative study of GPs’ attitudes to drug misusers and drug misuse services in primary care. Family Practice, 20, 120–125.PubMedCrossRef

McLaughlin, D. F., McKenna, H., & Leslie, J. C. (2000). The perceptions and aspirations illicit drug users hold toward health care staff and the care they receive. Journal of Psychiatric and Mental Health Nursing, 7, 435–441.PubMedCrossRef

Methadone Prescribing Implementation Committee (2005). Review of the Methadone Treatment Protocol. Dublin: Department of Health and Children. Available from: www.drugsandalcohol.ie/5962 (Accessed 12 December 2011).

Neville, R. G., McKellican, J. F., & Foster, J. (1988). Heroin users in general practice: ascertainment and features. British Medical Journal, 296, 755–758.PubMedCentralPubMedCrossRef

Noble, A., Best, D., Man, L., Gossop, M., & Strang, J. (2002). Self-detoxification attempts among methadone maintenance patients: what methods and what success? Addictive Behaviors, 27, 575–584.PubMedCrossRef

Nosyk, B., Marsh, D. C., Sun, H., Schecter, M. T., & Anis, A. H. (2010). Trends in methadone maintenance treatment participation, retention, and compliance to dosing guidelines in British Columbia, Canada: 1996–2006. Journal of Substance Abuse Treatment, 39, 22–31.PubMedCrossRef

Ormston, R., Bradshaw, P., & Anderson, S. (2010). Scottish social attitudes survey 2009: Public attitudes to drugs and drug use in Scotland. Edinburgh: Scottish Government Social Research.

Peterson, J., Schwartz, R., Mitchell, S., Schacht Reisinger, H., Kelly, S., O’Grady, K., et al. (2010). Why don’t out-of-treatment individuals enter methadone treatment programmes? The International Journal on Drug Policy, 21, 36–42.PubMedCentralPubMedCrossRef

Reisinger, H. S., Schwartz, R. P., Mitchell, S. G., Peterson, J. A., Kelly, S. M., O’Grady, K. E., et al. (2009). Premature discharge from methadone treatment: Patient perspectives. Journal of Psychoactive Drugs, 41, 285–296.PubMedCentralPubMedCrossRef

Richards, L. (2005). Handling qualitative data: A practical guide. London: Sage Publications.

Robertson, J. (1989). Treatment of drug misuse in the general practice setting. British Journal of Addict Ion, 84, 377–380.CrossRef

Roe, G. (2005). Harm reduction as paradigm: is better than bad good enough? The origins of harm reduction. Critical Public Health, 15, 243–250.CrossRef

Schuckit, M. (2006). Drug and alcohol abuse. A clinical guide to diagnosis and treatment (6th ed.). New York: Springer.

Sheerin, I., Green, T., Sellman, D., Adamson, S., & Deering, D. (2004). Reduction in crime by drug users on a methadone maintenance therapy programme in New Zealand. The New Zealand Medical Journal, 117, U795.PubMed

Simoens, S., Matheson, C., Bond, C., Inkster, K., & Ludbrook, A. (2005). The effectiveness of community maintenance with methadone or buprenorphine for treating opiate dependence. British Journal of General Practice, 55, 139–146.PubMedCentralPubMed

Stewart, D., Gossop, M., & Marsden, J. (2003). Methadone treatment: outcomes and variation in treatment response within NTORS. In J. Strang & G. Tober (Eds.), Methadone matters evolving community methadone treatment of opiate addiction (pp. 249–291). London: Martin Dunitz.CrossRef

Strang, J., McCambridge, J., Platts, S., & Groves, P. (2004). Engaging the reluctant GP in care of the opiate misuser. Pilot study of change-orientated reflective listening (CORL). Family Practice, 21, 150–154.PubMedCrossRef

Taylor, S. J., & Bogdan, R. (1984). Introduction to qualitative research methods: The search for meanings. New York: Wiley.

Teesson, M., Ross, J., Darke, S., Lynskey, M., Ali, R., Ritter, A., et al. (2006). One year outcomes for heroin dependence: findings from the Australian Treatment Outcome Study (ATOS). Drug and Alcohol Dependence, 83, 174–180.PubMedCrossRef

Van den Brink, W., & Haasen, C. (2006). Evidenced-based treatment of opioid-dependent patients. Canadian Journal of Psychiatry, 51, 635–646.

Van Hout, M. C., & Bingham, T. (2012). Methadone maintenance and special community employment schemes: a study of Irish participants’ views. Journal of Vocational Rehabilitation, 37, 63–73.

Van Hout, M. C., & McElrath, K. (2012). Service user involvement in drug treatment programs: Barriers to implementation and potential benefits for client recovery. Drugs Education, Prevention and Policy. Early Online, 1–10.

Winstock, A., Lintzeris, N., & Lea, T. (2011). Short report. “Should I stay or should I go?” Coming off methadone and buprenorphine treatment. The International Journal on Drug Policy, 22, 77–81.PubMedCrossRef

World Health Organisation (2009). Guidelines for the Psychosocially Assisted Pharmacological Treatment of Opioid Dependence. Geneva: World Health Organisation. Accessed on July 10th 2011 at www.who.com.

Wynne-Jones, G., Mallen, C. D., Main, C. J., & Dunn, K. M. (2010). Sickness certification and the GP: what really happens in practice? Family Practice, 27, 344–350.PubMedCrossRef

Titel: A Qualitative Study of Prescribing Doctor Experiences of Methadone Maintenance Treatment
verfasst von: Marie Claire Van Hout
Tim Bingham
Publikationsdatum: 01.06.2014
Verlag: Springer US
Erschienen in: International Journal of Mental Health and Addiction / Ausgabe 3/2014
Print ISSN: 1557-1874
Elektronische ISSN: 1557-1882
DOI: https://doi.org/10.1007/s11469-013-9436-3

Neu im Fachgebiet Psychiatrie

Demenzkranke durch Antipsychotika vielfach gefährdet

23.04.2024 Demenz Nachrichten

Wenn Demenzkranke aufgrund von Symptomen wie Agitation oder Aggressivität mit Antipsychotika behandelt werden, sind damit offenbar noch mehr Risiken verbunden als bislang angenommen.

Weniger postpartale Depressionen nach Esketamin-Einmalgabe

23.04.2024 Depression antepartal oder postpartal Nachrichten

Bislang gibt es kein Medikament zur Prävention von Wochenbettdepressionen. Das Injektionsanästhetikum Esketamin könnte womöglich diese Lücke füllen.

„Psychotherapie ist auch bei sehr alten Menschen hochwirksam!“

22.04.2024 DGIM 2024 Kongressbericht

Die Kombination aus Medikamenten und Psychotherapie gilt als effektivster Ansatz bei Depressionen. Das ist bei betagten Menschen nicht anders, trotz Besonderheiten.

Auf diese Krankheiten bei Geflüchteten sollten Sie vorbereitet sein

22.04.2024 DGIM 2024 Nachrichten

Um Menschen nach der Flucht aus einem Krisengebiet bestmöglich medizinisch betreuen zu können, ist es gut zu wissen, welche Erkrankungen im jeweiligen Herkunftsland häufig sind. Dabei hilft eine Internetseite der CDC (Centers for Disease Control and Prevention).

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2014

An Inpatient Treatment Program for People with Gambling Problems: Synopsis and Early Outcomes

A Structural Equation Model of Drug Abuse Among Secondary Students in Hong Kong

Moving Beyond Residential School Trauma Abuse: A Phenomenological Hermeneutic Analysis

Gambling Involvement: Considering Frequency of Play and the Moderating Effects of Gender and Age

Phases of Shopping Addiction Evidenced by Experiences of Compulsive Buyers