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Gender-specific predictors of retention and opioid abstinence during methadone maintenance treatment.
Levine, Amanda R; Lundahl, Leslie H; Ledgerwood, David M; Lisieski, Michael; Rhodes, Gary L; Greenwald, Mark K.
Afiliación
  • Levine AR; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: levinea@uwindsor.ca.
  • Lundahl LH; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: llundahl@med.wayne.edu.
  • Ledgerwood DM; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: dledgerw@med.wayne.edu.
  • Lisieski M; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: mlisiesk@med.wayne.edu.
  • Rhodes GL; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA. Electronic address: grhodes@med.wayne.edu.
  • Greenwald MK; Department of Psychiatry and Behavioral Neurosciences, School of Medicine, Wayne State University, 3901 Chrysler Service Drive, Detroit, MI 48201, USA; Department of Pharmacy Practice, Eugene Applebaum College of Pharmacy and Health Sciences, Wayne State University, 259 Mack Ave., Detroit, MI 48201,
J Subst Abuse Treat ; 54: 37-43, 2015 Jul.
Article en En | MEDLINE | ID: mdl-25795601
AIMS: Retention in methadone maintenance treatment (MMT) for 1 year is associated with positive outcomes including opioid abstinence, however, most studies have not investigated gender differences. We hypothesized that predictors of retention and opioid abstinence would differ between men and women, and aimed to determine which factors best predict retention and abstinence for each gender. METHODS: Data were available for 290 patients (173 M, 117 F) admitted to outpatient MMT. Regression analyses, stratified by gender, were conducted to identify unique predictors of MMT retention (<1 vs. >1 year) and opioid abstinence rate (proportion of opioid-free urine samples up to 1 year retention). RESULTS: Gender did not significantly predict treatment retention (mean = 231 days, 39% retained > 1 year) or opioid abstinence (49% overall). For males, significant predictors of > 1-year retention were urine samples negative for opioids (odds ratio [OR] = 6.67) and cannabinoids (OR = 5.00) during the first month, and not cocaine dependent (OR = 2.70). Significant predictors of higher long-term opioid abstinence were first-month urine samples negative for opioids and cocaine metabolites. For females, significant predictors of >1-year retention were first-month urine samples negative for cocaine metabolites (OR = 4.00) and cannabinoids (OR = 9.26), and no history of sexual victimization (OR = 3.03). The only significant predictor of higher opioid abstinence rate was first-month opioid-free urine samples. CONCLUSIONS: These findings indicate gender-specific predictors of MMT retention and opioid abstinence. Future studies on MMT outcomes should examine each gender separately, and consider unique pathways by which females and males adhere to, and benefit from MMT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tratamiento de Sustitución de Opiáceos / Metadona / Trastornos Relacionados con Opioides / Narcóticos Tipo de estudio: Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Subst Abuse Treat Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Tratamiento de Sustitución de Opiáceos / Metadona / Trastornos Relacionados con Opioides / Narcóticos Tipo de estudio: Prognostic_studies / Risk_factors_studies Aspecto: Determinantes_sociais_saude Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: J Subst Abuse Treat Asunto de la revista: TRANSTORNOS RELACIONADOS COM SUBSTANCIAS Año: 2015 Tipo del documento: Article Pais de publicación: Estados Unidos