Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment

Authors

  • Nieves Gudelia Martínez-Luna Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona.
  • Laia Rodríguez-Cintas Universidad Autónoma de Barcelona.
  • Abderraman Esojo Hospital Universitario Vall d'Hebrón.
  • Raúl Felipe Palma-Álvarez Hospital Universitario Vall d'Hebrón.
  • María Robles-Martínez Hospital Universitario Vall d'Hebrón.
  • Lara Grau-López Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona.
  • Marta Perea Hospital Universitario Vall d'Hebrón.
  • Carlos Roncero Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona. Universidad de Salamanca.

DOI:

https://doi.org/10.20882/adicciones.897

Keywords:

Harm reduction program, Methadone maintenance treatment, HIV, Hepatitis C, Heroine dependence

Abstract

Methadone maintenance programs (MMP) for opioid dependence treatment have been widely used due to their effective therapeutic outcomes. Harm reduction programs (HRP) are complementary programs for severe patients with high risk behaviors and when abstinence is not possible. This study aims to compare patients in MMP that use HRP (MMP-HRP) and patients in MMP who do not use HRP (MMP-NO HRP). The sample was composed of 143 patients (MMP-HRP = 42 vs. MMP-NO HRP = 101). An additional subanalysis was performed with patients under 45 years of age (n = 116; MMP-HRP = 38 vs. MMP-NO HRP = 78). All patients were assessed with an ad hoc socio-demographic questionnaire, EuropASI, SCID-I, and SCID-II. Results show that MMP-HRP patients were younger with more frequent use of intravenous drugs and with a high prevalence of Cluster B personality disorders. MMP-NO HRP patients had lower methadone doses compared to MMP-HRP patients and preferred to use drugs by smoked route more frequently. In the subanalysis of patients under 45, MMP-HRP patients were younger, had a higher prevalence of liver diseases, more intravenous drug use, greater severity on the drug use scale, less social and family support in the suescales of EUROP-ASI than compared to patients under 45 years in the group MMP-NO HRP. In conclusion, MMP-HRP patients are younger compared to MMP-NO HRP patients, they also receive higher doses of methadone and had more intravenous use. The above findings imply that the early onset of high risk drug use and long-term exposure to heroin have more severe outcomes such as higher comorbidities (e.g. infectious diseases, medical and psychiatric disorders), and consequently, these patients are a more vulnerable group with a worse prognosis.

Author Biographies

Nieves Gudelia Martínez-Luna, Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona (España). Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona- CIBERSAM (España). Departamento de Psiquiatría. Universidad Autónoma de Barcelona. (España).

Laia Rodríguez-Cintas, Universidad Autónoma de Barcelona.

Departamento de Psiquiatría. Universidad Autónoma de Barcelona.

Abderraman Esojo, Hospital Universitario Vall d'Hebrón.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona. Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona. CIBERSAM.

Raúl Felipe Palma-Álvarez, Hospital Universitario Vall d'Hebrón.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona. Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona. CIBERSAM.

María Robles-Martínez, Hospital Universitario Vall d'Hebrón.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona. Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona. CIBERSAM.

Lara Grau-López, Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona (España). Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona- CIBERSAM (España). Departamento de Psiquiatría. Universidad Autónoma de Barcelona. (España).

Marta Perea, Hospital Universitario Vall d'Hebrón.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona. Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona. CIBERSAM.

Carlos Roncero, Hospital Universitario Vall d'Hebron. Universidad Autónoma de Barcelona. Universidad de Salamanca.

Sección de Adicciones y Patología Dual. Servicio de Psiquiatría Hospital Universitario Vall d’Hebrón. ASPB, Barcelona (España). Servicio de Psiquiatría. Hospital Universitario Vall d’Hebrón. Barcelona- CIBERSAM (España). Departamento de Psiquiatría. Universidad Autónoma de Barcelona. (España). Psychiatric Service. University of Salamanca Health Care Complex (Complejo Asistencial Universitario de Salamanca/CAUSA), Salamanca, Spain. Institute of Biomedicine of Salamanca (IBSAL). University of Salamanca (Spain).

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Published

2018-01-15

Issue

Section

Originals