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

摘要

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 staffs growing experience and improvements in treatment but also to changes in patient characteristics over the past 2 decades.