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The impact of ongoing illicit drug use on methadone adherence in illicit drug users receiving treatment for HIV in a directly observed therapy program.
Drug Alcohol Depend. 2007 Jul 10; 89(2-3):306-9.DA

Abstract

INTRODUCTION

Studies evaluating the effectiveness of opioid agonist therapy programs typically evaluate drug abstinence or treatment retention as their primary outcomes. However, in many circumstances (e.g. directly observed therapy (DOT) programs within methadone maintenance programs), methadone adherence is an extremely relevant clinical outcome. We sought to evaluate the impact of ongoing illicit drug use on methadone adherence within a DOT program for the treatment of HIV-infection.

METHODS

Patients were enrolled in a DOT program, where methadone and HIV medication are co-administered by a community pharmacist. Drug use (amphetamines, benzodiazepines, cocaine, and opiates) was assessed by repeated urinalysis results. Methadone adherence was calculated as the fraction of days methadone was administered.

RESULTS

Ongoing drug use, and poly-substance use was common, with only 4 of 60 patients abstaining from all illicit drug use. Overall methadone adherence was 84.5%. Amphetamine use (without benzodiazepine and cocaine use), benzodiazepine use (without amphetamines) and higher methadone doses were associated with higher methadone adherence. When patients used benzodiazepines or cocaine, any positive effect associated with amphetamine use was negated. In addition, opiate use was associated with decreased methadone adherence.

DISCUSSION

The effect of many illicit drugs on methadone adherence may differ from reports using other treatment outcomes.

Authors+Show Affiliations

Department of Statistics, University of British Columbia, Vancouver, BC, Canada. jdraffa@uwaterloo.caNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17383117

Citation

Raffa, Jesse D., et al. "The Impact of Ongoing Illicit Drug Use On Methadone Adherence in Illicit Drug Users Receiving Treatment for HIV in a Directly Observed Therapy Program." Drug and Alcohol Dependence, vol. 89, no. 2-3, 2007, pp. 306-9.
Raffa JD, Grebely J, Tossonian H, et al. The impact of ongoing illicit drug use on methadone adherence in illicit drug users receiving treatment for HIV in a directly observed therapy program. Drug Alcohol Depend. 2007;89(2-3):306-9.
Raffa, J. D., Grebely, J., Tossonian, H., Wong, T., Viljoen, M., Khara, M., Mead, A., McLean, M., Duncan, F., Petkau, A. J., DeVlaming, S., & Conway, B. (2007). The impact of ongoing illicit drug use on methadone adherence in illicit drug users receiving treatment for HIV in a directly observed therapy program. Drug and Alcohol Dependence, 89(2-3), 306-9.
Raffa JD, et al. The Impact of Ongoing Illicit Drug Use On Methadone Adherence in Illicit Drug Users Receiving Treatment for HIV in a Directly Observed Therapy Program. Drug Alcohol Depend. 2007 Jul 10;89(2-3):306-9. PubMed PMID: 17383117.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The impact of ongoing illicit drug use on methadone adherence in illicit drug users receiving treatment for HIV in a directly observed therapy program. AU - Raffa,Jesse D, AU - Grebely,Jason, AU - Tossonian,Harout, AU - Wong,Tiffany, AU - Viljoen,Mark, AU - Khara,Milan, AU - Mead,Annabel, AU - McLean,Mark, AU - Duncan,Fiona, AU - Petkau,A John, AU - DeVlaming,Stanley, AU - Conway,Brian, Y1 - 2007/03/23/ PY - 2006/08/04/received PY - 2007/02/04/revised PY - 2007/02/06/accepted PY - 2007/3/27/pubmed PY - 2007/8/19/medline PY - 2007/3/27/entrez SP - 306 EP - 9 JF - Drug and alcohol dependence JO - Drug Alcohol Depend VL - 89 IS - 2-3 N2 - INTRODUCTION: Studies evaluating the effectiveness of opioid agonist therapy programs typically evaluate drug abstinence or treatment retention as their primary outcomes. However, in many circumstances (e.g. directly observed therapy (DOT) programs within methadone maintenance programs), methadone adherence is an extremely relevant clinical outcome. We sought to evaluate the impact of ongoing illicit drug use on methadone adherence within a DOT program for the treatment of HIV-infection. METHODS: Patients were enrolled in a DOT program, where methadone and HIV medication are co-administered by a community pharmacist. Drug use (amphetamines, benzodiazepines, cocaine, and opiates) was assessed by repeated urinalysis results. Methadone adherence was calculated as the fraction of days methadone was administered. RESULTS: Ongoing drug use, and poly-substance use was common, with only 4 of 60 patients abstaining from all illicit drug use. Overall methadone adherence was 84.5%. Amphetamine use (without benzodiazepine and cocaine use), benzodiazepine use (without amphetamines) and higher methadone doses were associated with higher methadone adherence. When patients used benzodiazepines or cocaine, any positive effect associated with amphetamine use was negated. In addition, opiate use was associated with decreased methadone adherence. DISCUSSION: The effect of many illicit drugs on methadone adherence may differ from reports using other treatment outcomes. SN - 0376-8716 UR - https://www.unboundmedicine.com/medline/citation/17383117/The_impact_of_ongoing_illicit_drug_use_on_methadone_adherence_in_illicit_drug_users_receiving_treatment_for_HIV_in_a_directly_observed_therapy_program_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0376-8716(07)00073-7 DB - PRIME DP - Unbound Medicine ER -