Why do Patients Stay in Opioid Maintenance Treatment?

Abstract

Opioid maintenance treatment (OMT) successfully improves social functioning and leads to an increase of survival rates, by reducing drug-related mortality and infections. A region-wide anonymous survey was performed to evaluate subjective factors that could potentially contribute to growing numbers of patients in OMT in the city of Berlin, Germany. In the survey, performed in 2011, 46 staff members and 986 patients participated. Both patients and staff members report beneficial effects of OMT on physical and mental health, and reduction of criminality. Patients on average consider the detoxification from OMT more difficult than from heroin. Staff members underestimate the wish of patients to reach abstinence of OMT. We conclude that besides reduced mortality, these subjective factors may contribute to a growing number of patients in OMT. No financial or material support was received in any phase of the study.

Keywords :

• methadone
• opioid
• maintenance
• treatment
• patients perspective

THE AUTHORS

Stefan Gutwinski, M.D., PhD. Stefan Gutwinski is medical doctor in the Department of Psychiatry and Psychotherapy, Charité Campus St. Hedwig Hospital, Berlin. His main field of research is treatment and epidemiology of addiction.

Lena Karoline Bald, M.D., PhD. Lena Karoline Bald is Postdoc in the Department of Psychiatry and Psychotherapy, Charité Campus St. Hedwig Hospital, Berlin. Her main field of research is epidemiology of opioid dependence.

Jürgen Gallinat, M.D., PhD, Professor of Psychiatry, Charité, Universitätsmedizin Berlin. He is chief physician of the Department of Psychiatry and Psychotherapy, Charité Campus St. Hedwig Hospital, Berlin. His main field of research is multimodal brain imaging in psychiatry.

Andreas Heinz, M.D., PhD, Professor of Psychiatry, Charité Universitätsmedizin Berlin. He is director of the Department of Psychiatry and Psychotherapy Charité Campus Mitte and of the Charité Campus St. Hedwig Hospital, Berlin. He is elected as a Leibnitz chair at the Leibnitz-Institute for Neurobiology in Magdeburg, in recognition of outstanding research in Neuroscience. His main field of research is transcultural psychiatry, treatment, and neurobiology of psychosis and addiction.

Felix Bermpohl, M.D., PhD, Professor of Psychiatry, Charité Universitätsmedizin Berlin. He is head of the addiction disorders unit and consultant in the Department of Psychiatry and Psychotherapy, Charité Campus St. Hedwig Hospital, Berlin. His main field of research is emotional processing in psychiatric disorders.