Heroin Addiction and Related Clinical Problems 2010; 12(1):5-16

Evaluation of Opioid-Dependent Prisoners in Oral Opioid Maintenance Therapy

Metz V., Matzenauer C., Kammerer K., Winklbaur B., Ebner N., Radler D., Fischer G.

Correspondence: Prof. Gabriele Fischer, Medical University of Vienna, Department of Psychiatry and Psychotherapy, Waehringer Guertel 18-20 - 1090 Vienna, Austria

Phone: +43 1 40400 2117; Fax: +43 1 40400 3629; E-mail: gabriele.fischer@meduniwien.ac.at

Summary: Background: Opioid maintenance treatment is available in prison in many countries, but without a specific methodology or homogeneity. The aim of our study was to investigate characteristics and differences among opioid-dependent prisoners in an Austrian penitentiary. Methods: Structured assessments were obtained from 57 (78.1%) of 73 opioid-maintained prisoners on their demographic data, imprisonment terms, health status and quality of life. Results: From 1996 until 2007, the number of opioid-maintained detainees increased by 444%. Prisoners treated with methadone had significantly more convictions (p=0.036) and a longer duration of polydrug abuse (p=0.093) and opioid consumption (p=0.05) than patients maintained on slow-release morphine. Conclusions: There is a strong need for a diversification of opioid maintenance treatments, as well as the development of a specific methodology for the use of therapeutic opioids in prison.

 

Publication Type: Regular article

 

Heroin Addiction and Related Clinical Problems 2010; 12(1):17-24

Dose Determination in Dual Diagnosed Heroin Addicts during Methadone Treatment

Maremmani I., Pacini M., Canoniero S., Deltito J., Maremmani A. G. I., Tagliamonte A.

Correspondence: Icro Maremmani, MD; Vincent P. Dole Dual Diagnosis Unit, Santa Chiara University Hospital, Department of Psychiatry, University of Pisa, Via Roma, 67 56100 PISA, Italy, EU. Phone +39 0584 790073 Fax +39 0584 72081 E-Mail: maremman@med.unipi.it

Summary: Ninety-nine consecutive responders to treatment for heroin addiction (54 with one or more Axis I psychiatric diagnosis (DD-patients), and 45 without psychiatric comorbidity (NDD-patients), were monitored prospectively (20 months on average, min.1, max. 51), in order to achieve some useful clinical information pertaining to effective methadone dose determination for double diagnosed heroin addicts. First day and first month dosages do not differ between the two groups. Stabilization dosages are higher in DD patients than in NDD patients. The time to reach stabilization phase is longer in DD patients than in NDD patients. Tapering of methadone follows a similar trend in both groups. DD patients need more attention from clinicians, especially when stabilization dosage has to be established.

Publication Type: Regular article

 

Heroin Addiction and Related Clinical Problems 2010; 12(1):25-32

Urine Labelling Marker System for Drug Testing Improves Patient Compliance

Simojoki K., Alho A.

Correspondence: Hannu Alho, Ph.D., M.D.; National Institute of Health and Welfare, Department of Mental Health and Substance Abuse Services. POB 30, 00271 Helsinki, Finland

Phone: +358-20-6108123 Fax: +358-20-6108133 E-mail: hannu.alho@thl.fi

Summary: Urine drug testing plays an important role in substance abuse treatments. When strictly controlled, as it often is, urine sampling creates a humiliating situation and ties up resources. A new sample labelling method has been developed to make supervision unnecessary. This innovation is achieved by labelling the urine with polyethylene glycols. In this study, 57 patients who required urine sampling were randomized into two groups, the traditional supervised (TS) group and the new marker (NM) group. The urine test return rate was 98.3% in the NM group and 100% in the TS group. Attempts to manipulate the urine samples were discovered in 2% of the NM group and 0% of the TS group. Most patients preferred the NM testing method. The personnel too preferred the NM system, and estimated that it reduced their workload dedicated to drug screening by 50%. We conclude that the NM method is more acceptable to patients and personnel, and may increase compliance as a result.

Publication Type: Regular Article

 

Heroin Addiction and Related Clinical Problems 2010; 12(1):33-36

Quality of Life As a Means of Assessing Outcome in Opioid Dependence Treatment

Torrens M.

Correspondence: Marta Torrens MD, Drug Addiction Unit, IAPS-Hospital del Mar, Barcelona, Universitat Autònoma de Barcelona, Barcelona, Spain, E-mail mtorrens@imas.imim.es

Summary: Not available

Publication Type: Letter to the editor

 

Heroin Addiction and Related Clinical Problems 2010; 12(1):37-40

Why There Has Been an Excess of Overdoses in Norway Since 1990?

Haraldsen M.

Correspondence: Martin Haraldsen, Rodslia 12, 3222 Sandefjord, Norway

 E-mail: mar.har@c2i.net

Summary: Not available

Publication Type: