Reducing Risky Drug Use Behaviors by Enrolling Syringe Exchange Registrants in Methadone Maintenance

Abstract

Background

Referral of syringe exchange registrants with opioid use disorder to agonist treatment provides a pathway to further reduce drug use risk behaviors. Objective: This study evaluates the drug use risk reduction benefits of enrolling syringe exchange registrants in methadone maintenance, and the impact of continued illicit drug use on risk reduction. Method: Baltimore Needle Exchange Program (BNEP) registrants (n = 210) participated in a parent study evaluating treatment initiation strategies for methadone maintenance and were followed for six months. The Risk Assessment Battery (RAB; Metzger, 1993) was administered monthly to evaluate drug use risks; urinalysis testing was conducted weekly. Results: Treatment enrollment reduced drug use risk behaviors, and longer treatment episodes resulted in additional, though modest, risk reduction. Use of opioids or cocaine in treatment diminished risk-reduction benefits, though drug use risks declined over time and remained well below baseline levels. Conclusions: These findings demonstrate that methadone maintenance enhances the well-known risk-reduction benefits of syringe exchange participation. Improving coordination between syringe exchanges and treatment facilities may enhance the public health.

Keywords:

• Syringe exchange
• opioid agonist treatment
• opioid use disorder

Acknowledgements

We gratefully acknowledge staff from the Baltimore Needle Exchange Program and Addiction Treatment Services for their contributions to this research. We also acknowledge Haijuan Yan for her assistance in conducting statistical analyses. Finally, we acknowledge and thank the research staff whose diligence ensured both the quality and integrity of the study, especially Kori Kindbom, M.A., Jim Blucher, M.A., Rachel Burns, B.A., Mark Levinson, M.A., Jennifer Mucha, M.A, Michael Sklar, M.A.

Declaration of interest

The authors declare that they have no conflict of interest. The authors alone are responsible for the content and writing of the article.

Additional information

Funding

This study was supported by research grants RO1 DA 12347 and R34 DA 042320 (M. Kidorf, PI) from the National Institute on Drug Abuse.