11 Apr Can We Predict Which Methadone Users Will Keep Abusing Opioid Drugs?
Methadone is an opioid medication frequently used to treat people addicted to powerful opioid drugs of abuse. As a rule, this medication is intended to replace any other form of opioid intake; however, significant numbers of methadone patients continue to abuse opioid drugs during treatment. In a study published in February 2014 in the journal Drug and Alcohol Dependence, a team of French researchers sought to determine if it’s possible to predict which methadone users will continue to engage in opioid drug abuse during treatment.
Methadone is typically used as a replacement for heroin. It’s useful in this role for a couple of basic reasons. First, methadone produces less of a euphoric high than heroin; in addition, methadone produces its effects inside the body at a slower rate than heroin. In combination, these two facts mean that methadone use poses a substantially smaller threat to health and well-being than heroin use. Some people receive doses of the medication temporarily while going through short-term withdrawal in the addiction recovery process. However, doctors often give their patients methadone for much longer periods of time as part of an ongoing replacement approach called methadone maintenance treatment (MMT) or opioid maintenance treatment. Use of MMT can provide advantages that include avoidance of severe opioid withdrawal and avoidance of many of the personal and social harms commonly associated with the unrestrained intake of heroin.
Potential for Continuing Abuse
Methadone use does not eliminate the possibility that a person in recovery from opioid addiction will continue to participate in opioid abuse while in treatment. In fact, since methadone is itself an opioid substance, users of the medication can engage in opioid abuse merely by misusing their prescriptions. As a rule, methadone users can minimize their risks for problems by closely following the guidelines set forth by their doctors. However, some people have increased risks for experiencing problems with methadone abuse or other forms of opioid abuse while taking part in treatment. Examples include individuals who don’t receive counseling or psychotherapy as part of their overall treatment plan, individuals who drink substantial amounts of alcohol or take non-opioid drugs of abuse and individuals who take certain medications prescribed for the treatment of ailments such as epilepsy or tuberculosis.
In the study published in Drug and Alcohol Dependence, researchers from six French institutions examined the factors that could potentially help predict who will continue to abuse opioids while receiving methadone maintenance treatment. They decided to explore this subject because researchers and doctors currently have only limited information regarding the risks involved. The researchers gathered their data from a group of 158 adults who had received methadone for a year. Risk factors assessed in this group include the relative ability to sustain a cooperative relationship between a patient and his or her doctor, exposure to untreated heroin users, excessive alcohol intake and the use of non-opioid drugs during treatment.
The researchers found that almost one-third (32.3 percent) of the study participants abused an opioid substance over the course of a year of methadone maintenance treatment. They concluded that the single factor most likely to predict such abuse is the inability to get along well with one’s doctor. Other prominent factors that help predict opioid abuse while receiving methadone include living with an active heroin user after one year of methadone maintenance enrollment, having an excessive pattern of alcohol intake at the beginning of methadone treatment and taking part in cocaine use while enrolled in methadone maintenance treatment.
Significance and Considerations
The authors of the study published in Drug and Alcohol Dependence concluded that the single factor most likely to predict successful avoidance of opioid abuse during methadone treatment is the ability to relate well with the doctor providing that treatment. As a result of their findings, they believe that the outcomes of methadone maintenance could be improved substantially by focusing on ways to improve doctor-patient interactions. They also believe that outcomes of the treatment could be improved by providing proper care for the heroin-addicted partners and associates of individuals participating in methadone maintenance, as well as by persuading treatment participants to decrease the number of drug and alcohol users present in their peer groups.
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