Involving significant others in the care of opioid-dependent patients receiving methadone

Department of Psychiatry and Behavioral Sciences, Johns Hopkins Bayview Medical Center, The Johns Hopkins University School of Medicine, Baltimore, MD 21224, USA.
Journal of Substance Abuse Treatment (Impact Factor: 3.14). 08/2005; 29(1):19-27. DOI: 10.1016/j.jsat.2005.03.006
Source: PubMed

ABSTRACT Positive, abstinence-oriented, social support is associated with good substance abuse treatment outcome but few interventions are designed to help patients improve their social supports. This article reports on a behavioral intervention designed to encourage opioid-dependent patients receiving methadone to include drug-free family members or friends in treatment and to use these individuals to facilitate development of a supportive, non-drug-using social network. This report uses data from a quality assurance program review of the treatment response of 59 opioid-dependent outpatients who identified a drug-free significant other to participate in their treatment. Fifty-five (93.2%) brought a significant other (most often the patient's mother, 29%) to both the initial evaluation session and at least one joint session. Social support activities were family- (33%), church- (28%), and self-help group-related (30%). Approximately 78% of patients who participated in the social support intervention achieved at least four consecutive weeks of abstinence. Women responded better than men. We conclude that methadone-maintained patients can and will include non-drug-using family members and friends in treatment, and these individuals can be mobilized to help patients improve their recovery.

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Available from: Karin J Neufeld, Sep 27, 2015
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    • "Greater improvement in HCV knowledge occurred among those with non-drug using sex partners. Kidorf and colleagues [40] reported that positive social support is associated with positive outcomes among opioid-dependent patients. "
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    ABSTRACT: This randomized, controlled study (n = 256) was conducted to compare three interventions designed to promote hepatitis A virus (HAV) and hepatitis B virus (HBV) vaccination completion, among clients undergoing methadone maintenance treatment (MMT) in Los Angeles and Santa Monica. The participants were randomized into three groups: Motivational Interviewing-Single Session (MI-Single), Motivational Interviewing-Group (MI-Group), or Nurse-Led Hepatitis Health Promotion (HHP). All three treatment groups received the 3-series HAV/HBV vaccine. The MI sessions were provided by trained therapists, the Nurse-Led HHP sessions were delivered by a research nurse. The main outcome variable of interest was improvement in HBV and HCV knowledge, measured by a 6-item HBV and a 7-item HCV knowledge and attitude tool that was administered at baseline and at 6-month follow-up. The study results showed that there was a significant increase in HBV- and HCV-related knowledge across all three groups (p < 0.0001). There were no significant differences found with respect to knowledge acquisition among the groups. Irrespective of treatment group, gender (P = 0.008), study site (P < 0.0001) and whether a participant was abused as a child (P = 0.017) were all found to be predictors of HCV knowledge improvement; only recruitment site (P < 0.0001) was found to be a predictor of HBV knowledge. The authors concluded that, although MI-Single, MI-Group and Nurse-Led HHP are all effective in promoting HBV and HCV knowledge acquisition among MMT clients, Nurse-Led HHP may be the method of choice for this population as it may be easier to integrate and with additional investigation may prove to be more cost efficient.
    Journal of Community Health 04/2010; 35(4):423-32. DOI:10.1007/s10900-010-9266-1 · 1.28 Impact Factor
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    • "Evidence suggests that positive social supports are associated with higher rates of adherence to treatment protocols and successful treatment outcomes (Dawson et al., 2005; McKellar, Kelly, Harris & Moos, 2006; Moos & Moos, 2005; Schutte, Nichols, Brennan, & Moos, 2003). In addition, numerous studies have also shown that positive social supports are associated with a reduced risk of relapse to heroin and other drug use, and with an overall better treatment response (Booth, Russell, Soucek, & Laughlin, 1992; Broome, Simpson, & Joe, 2002; Cohen & Lichtenstein, 1990; Goehl, Nunes, Quitkin, & Hilton, 1993; Havassy, Hall, & Wasserman, 1991, Kidorf et al., 2005; Wasserman, Stewart, & Delucchi 2001; Yates, Booth, Reed, Brown, & Masterson, 1993). "
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    ABSTRACT: The purpose of this study is to explore barriers to the use, maintenance, and expansion of social supports in older adult methadone clients. The data for this analysis were derived from a qualitative study of the needs of aging methadone clients. Data were collected through face-to-face interviews with 24 methadone clients over the age of 50. A lack of trust was identified as a principal barrier to the use, maintenance, and expansion of the social supports of older adult methadone clients. Causes of this mistrust include issues associated with aging, past traumatic experiences, and difficult personal relationships. These findings imply that addressing the issue of self isolation and recognizing the reason older adult methadone clients engage in this behavior is a key element in getting this specific population to use, maintain, and foster healthy social supports. A common phrase echoed throughout the interviews is that a person cannot trust anybody. Because of this mistrust, some clients keep to themselves by electing to self-isolate and decline to use, maintain, or foster new relationships. As a result, these individuals are less likely foster and/or engage in healthy social relationships, which are a key component of substance abuse treatment and abstinence maintenance.
    Journal of Gerontological Social Work 10/2009; 52(7):653-67. DOI:10.1080/01634370802609049
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