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A General Method for Evaluating Deep Brain Stimulation Effects on Intravenous Methamphetamine Self-Administration

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What is low threshold methadone maintenance treatment?

Carol Strike¹, Margaret Millson¹, Shaun Hopkins²

¹Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, Ontario M5T 3M7, Canada.

The International Journal on Drug Policy

|June 8, 2013

Summary

Low threshold methadone maintenance (MMT) programs reject abstinence as a goal, focusing instead on reducing barriers to treatment and improving retention for opiate-dependent individuals. Challenges arise from differing professional perspectives on practices like drug testing and appointment adherence.

Keywords:

Canada Harm reduction Low threshold Methadone maintenance Program policies

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Area of Science:

Addiction Medicine
Public Health
Sociology

Background:

Low threshold methadone maintenance (MMT) offers an alternative for individuals not seeking abstinence.
Exploration of how Canadian MMT programs define and implement low-threshold approaches.

Purpose of the Study:

To investigate the definition and practical implementation of low threshold methadone maintenance (MMT) in Canada.
To identify challenges faced by MMT programs in reducing barriers and improving client retention.

Main Methods:

Semi-structured interviews with 46 clients, 15 nurses/counsellors, and 9 physicians across three low threshold MMT programs.
Thematic coding analysis of interview data to understand definitions and implementation of low threshold MMT.

Main Results:

Low threshold MMT explicitly rejects abstinence, prioritizing reduced admission barriers and retention.
Disagreements among staff regarding practices like urine drug testing and consequences for missed appointments highlight differing priorities.
Physicians experience tension between harm reduction (poly-drug use) and patient well-being.

Conclusions:

Current literature may not fully capture the diverse strategies for reducing MMT barriers.
Findings are crucial for addressing global opiate dependence and expanding MMT access.
Further evaluation of policies and practices is needed to optimize MMT's effectiveness in reducing barriers and enhancing retention.