‘Take home’ methadone maintenance therapy has added benefits

By Piriya Mahendra

Patients who are given "take home" methadone maintenance treatment (MMT) for opioid dependence are less likely to be admitted to hospital than those who do not, a study shows.

Patients who received take home MMT after exhibiting treatment successes, including regular attendance at clinic and counseling sessions and passing urine screening for illicit drug use, were 74% less likely to be hospitalized over 20 months than patients who did not take home MMT.

During a mean follow-up period of 20 months, 42 (30%) patients accounted for 80 hospital admissions. Of these, nine (11%) occurred in patients on take home MMT.

As reported in the Journal of Addiction Medicine, receipt of take home MMT was associated with a significantly lower risk for hospital admission, at an adjusted odds ratio of 0.26.

Receiving a methadone dose of 80 mg or more was not significantly associated with a lower risk for hospitalization, contradicting previous reports that have found methadone doses of over 80 mg are more effective than lower doses in curbing illicit drug cravings.

"These study results add to the mounting evidence that patients who are successful in their addiction treatment are also improving their overall health, which could result in a reduction of health care utilization," commented lead author Alexander Walley (Boston Medical Center, Massachusetts, USA) in a press statement.

"We have demonstrated an association between take home status and hospitalization, which is an important medical and health system cost outcome that needs to be considered as we further explore the benefits of addiction treatment to the patient and health care system as a whole."

For the study, Wally and team reviewed the daily electronic medical records of 138 patients enrolled in an MMT program.

The patients had a mean age of 43 years and 52% were female. Of the total cohort, 17% had HIV, 32% had a medical illness, 40% had a mental illness, and 52% reported polysubstance use.

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