Longer retention in drug abuse treatment is associated with better patient outcomes, and research indicates the first 12 months of methadone treatment are critical to patient success. Nevertheless, large-scale multisite longitudinal studies over the past three decades indicate that the majority of patients drop out during the first year of methadone treatment. Through an examination of 42 qualitative interviews with patients prematurely discharged from six methadone treatment programs in Baltimore, this study highlights factors patients describe as contributing to their reasons for being discharged within the first 12 months of the treatment. The two most consistent themes are program-related factors and incarceration. The former factors are richly described through patients' words and underscore the ways in which patients' perceptions of control exerted by the program and by the medication and misunderstandings of program structure can lead to premature discharge. Patients' reasons for discharge were compared to counselors' reasons as indicated in discharge summary forms. An analysis of the patterns of agreement and disagreement are presented. Patient-centered program and policy implications are discussed.
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http://dx.doi.org/10.1080/02791072.2009.10400539 | DOI Listing |
Eur J Trauma Emerg Surg
January 2025
Division of Acute Care Surgery, Department of Surgery, University of Southern California, 2051 Marengo Street, Los Angeles, CA, 90033, USA.
Purpose: The aim of this study was to explore the association between pre-injury narcotic drug use (opioids, methadone, and/or oxycodone) and outcomes in isolated severe traumatic brain injury (TBI) patients.
Methods: ACS TQIP study included adult trauma patients (≥ 16 years) with complete drug and alcohol screening. Isolated severe TBI was defined as head trauma with AIS 3-5 and without significant extracranial trauma.
Drug Alcohol Depend Rep
March 2025
Center to Improve Veteran Involvement in Care, VA Portland Health Care System, 3710 SW US Veterans Hospital Rd, Portland, OR 97239, United States.
Aim: We examined differences in medications for opioid use disorder (MOUD) receipt between rural and urban veteran patients following initiatives within the US Department of Veterans Affairs (VA) to expand access to MOUD.
Methods: Data for this retrospective cohort study were obtained from the VA Corporate Data Warehouse, which contains national electronic health record data for all VA patients. The analytic sample included all patients diagnosed with OUD from 10/1/2018-9/30/20.
Pain Manag
January 2025
Department of Pain Medicine, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Introduction: The QTc prolongation effect of methadone has been extensively studied at higher doses commonly used in opioid dependence maintenance therapy, but evidence remains limited regarding its impact at the lower doses typically prescribed for cancer pain. This study aims to evaluate the effect of oral methadone on QTc intervals in cancer pain patients.
Methods: A retrospective analysis was performed on adult patients initiated on oral methadone therapy for cancer.
Curr Res Toxicol
December 2024
University of Central Florida, NanoScience Technology Center, 12424 Research Parkway, Suite 400, Orlando, FL 23826, United States.
Opioids have been the primary method used to manage pain for hundreds of years, however the increasing prescription rate of these drugs in the modern world has led to a public health crisis of overdose related deaths. Naloxone is the current standard treatment for opioid overdose rescue, but it has not been fully investigated for potential off-target toxicity effects. The current methods for pharmaceutical development do not correlate well with pre-clinical animal studies compared to clinical results, creating a need for improved methods for therapeutic evaluation.
View Article and Find Full Text PDFJ Gen Intern Med
January 2025
Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
Background: Hepatitis C virus (HCV) infections and injection drug use have concurrently increased in the last decade. Evidence supports simultaneously treating chronic HCV and opioid use disorder (OUD) with medication. Kentucky is a hard-hit state for both conditions that has undertaken policy and practice efforts to increase access to both types of medications.
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