Trends in Substance Abuse and Infectious Disease Over 20 Years in a Large Methadone Maintenance Treatment (MMT) Clinic in Israel

ABSTRACT

Background: The objective was to study substance abuse, infectious disease, and patient outcomes (retention and substance abuse abstinence) over 2 decades in a large methadone maintenance treatment (MMT) facility within a tertiary-referral medical center.Methods: Prevalence of substance abuse was determined monthly between 1993 (35 patients) and 2013 (350 patients) based on observed random urine tests. On entry, patients were tested for hepatitis C and human immunodeficiency virus (HIV) antibodies. One-year retention and substance abuse abstinence were calculated. Results: At admission, mean age and rate of cocaine and benzodiazepines abuse increased over the years, with no change in the prevalence of hepatitis C (50%) and HIV (<10%). Retention rate increased (P = .008) (range: 42.9%–92.4%; overall: 76.2%) and opiate abstinence also increased (P = .006) (range: 49.1%–85.7%; overall: 68.1%), reflecting outcome improvement over the years.Conclusions: Outcome improvement could be attributed to the staff's growing experience and improvements in treatment but also to changes in patient characteristics over the past 2 decades.

Keywords:

• Hepatitis C
• HIV
• outcome
• methadone maintenance treatment
• substance abuse trends

ACKNOWLEDGEMENTS

The authors thank Esther Eshkol for English editing.

AUTHOR CONTRIBUTIONS

Dr. Peles and Prof. Schreiber designed the study. All authors discussed the results and discussion. Dr. Peles performed data analyses.

Additional information

Funding

Funding was provided by the Adelson Family Foundation. The funding agency was not involved in the design of the study, in the collection of data, nor in the elaboration of findings.