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Abstract
This study investigated the role of psychological variables and judicial problems in treatment retention for a low-threshold methadone program in Montreal, Canada. Logistic regression analyses were computed to examine associations between psychological variables (psychological distress, self-esteem, stages of change), criminal justice involvement, and treatment retention for 106 highly-disorganized opioid users. Higher methadone dosage was associated with increased odds of treatment retention, whereas criminal charges and lower self-esteem decreased these odds. Psychological variables could be identified early in treatment and targeted to increase potential treatment retention. Financial support for this study was provided by the Fonds de Recherche en Santé du Québec.
THE AUTHORS
Michel Perreault, Ph.D., is a psychologist and researcher at the Douglas Mental Health University Institute and an Associate Professor in the Department of Psychiatry at McGill University. He is also a member of the Groupe de recherche et intervention sur les substances psychoactives-Québec (RISQ) and an associate researcher at the Centre de réadaptation en dépendance de Montréal –Institut universitaire. His research interests include program and treatment evaluation in mental health and addiction and the development, implementation and evaluation of training programs for staff and peer helpers.
Dominic Julien, Ph.D., is an investigator associated with the Lady Davis Institute of the Jewish General Hospital in Montreal, Canada. He worked at the Douglas Hospital as a research assistant. He has completed a Ph.D. in Psychology and a postdoctoral fellowship in public health at the Université de Montréal. His research interests include addiction, obsessive-compulsive disorder, and the role of neighborhood environments, walking, and social participation in depression.
Noé Djawn White, B.Sc., was a Research Assistant to Dr. Michel Perreault at the time of the study. During that time, he collaborated on various articles and research done by Dr. Perreault's team. He now works at the McGill University Health Center (MUHC) as a Continuous Improvement Advisor.
Daniel Rabouin, M.Sc., is a senior research analyst and programmer at the Douglas research Institute, which is affiliated with McGill University. He is currently involved with the At Home (Chez Soi) project at the Montreal site, which is a multi-site pragmatic trial project of housing first in five Canadian cities.
Pierre Lauzon, MD, a family physician by training, has been practicing exclusively in addiction medicine for the past 20 years. He contributed to the development of substitution treatment for opioid addiction, in Montreal and the province of Quebec since the mid-eighties. He has been a staff physician in the service of Addiction Medicine of the Centre Hospitalier de l'Université de Montréal (CHUM) since 1990. He is involved in clinical teaching in the department of family medicine of Université de Montréal. As a researcher, he was involved in the NAOMI project (ended in 2009) which compared standard methadone treatment and IV heroin administered under supervision, in patients who have been resistant to standard treatment in the past.
Diana Milton, B.Sc., is a member of Dr. Michel Perreault's research team at the Douglas Mental Health University Institute. Her areas of interest include program and service evaluation in mental health and addiction.