Evidence-based treatment for opioid use disorders: A national study of methadone dose levels, 2011–2017
| Autor: | Harold A. Pollack, Thomas D'Aunno, Sunggeun (Ethan) Park |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
Methadone maintenance Evidence-based practice Medicine (miscellaneous) Article Surveys and Questionnaires mental disorders Opiate Substitution Treatment medicine Humans Dosing Opioid epidemic Evidence-Based Medicine Dose-Response Relationship Drug business.industry Opioid use Opioid-Related Disorders Methadone dose Psychiatry and Mental health Clinical Psychology Family medicine National study Pshychiatric Mental Health business Methadone medicine.drug |
| Zdroj: | Journal of Substance Abuse Treatment. 96:18-22 |
| ISSN: | 0740-5472 |
| Popis: | The nation’s methadone maintenance treatment (MMT) programs play a central role in addressing the current opioid epidemic. Considerable evidence documents the treatment effectiveness of MMT and, in turn, the importance of adequate dosing to MMT’s effectiveness. Yet, as recently as 2011, 41% of patients received doses below the level of 80mg/day. Using survey data from a nationally representative sample of MMT programs in 2011 and 2017, we examine (1) the extent to which the nation’s MMT programs are meeting evidence-based standards for methadone dose level and (2) characteristics of MMT programs that are associated with variation in performance. Our results show that forty-three percent of MMT patients receive less than 80mg/day in 2017, and 23% of methadone maintenance patients receive daily doses below 60mg. Results from multivariate regression analysis of the 2017 survey data show that private for-profit and public organizations significantly under-dosed patients compared to private nonprofit providers. Under-dosing also was more common in programs that serve high proportions of African-American patients. These results are concerning because MMT remains the medication of choice for vulnerable patients with the most severe opioid use disorders, and for-profit providers treat a growing proportion of MMT patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect