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Published on: November 11, 2013
Take home maintenance medication in opiate dependence.
Stefan Gutwinski1, Lena Karoline Bald, Andreas Heinz
1Psychiatric University Hospital Charité, St. Hedwig Hospital, Berlin, Germany. Stefan.Gutwinski@charite.de
Deutsches Arzteblatt International
|July 10, 2013
Summary
Patients receiving take-home opiate maintenance medication generally meet German guidelines. This study found they reported less substance abuse and better employment than daily-dispensed patients.
Area of Science:
- Addiction Medicine
- Pharmacology
- Public Health
Background:
- Opiate maintenance therapy (OMT) allows take-home medication for patient convenience.
- German Medical Association guidelines outline criteria for take-home OMT eligibility.
- These criteria include abstinence from illicit substances, psychosocial stability, and clinical stabilization.
Purpose of the Study:
- To evaluate if patients receiving take-home OMT in Berlin adhere to German Medical Association guidelines.
- To compare substance use, employment, and clinical status between patients receiving take-home OMT and those receiving daily medication.
Main Methods:
- A questionnaire survey was conducted from May to October 2011.
- Data were collected from patients across 20 psychiatric hospitals and 110 practices in Berlin.
- 5032 patients on OMT were invited, with 986 (19.9%) responding.
Main Results:
- 38.2% of surveyed patients received take-home medication.
- Take-home patients showed significantly lower rates of additional health-endangering substance use (56.0% vs. 69.9%, p<0.0001).
- Take-home recipients were more frequently employed and longer in treatment (p<0.0001), with similar clinical stabilization.
Conclusions:
- The study suggests that most patients receiving take-home OMT in Berlin meet the established German guidelines.
- Take-home OMT may be associated with improved patient outcomes, including reduced substance use and better social integration.
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