Heroin or conventional opioid maintenance? The patients' perspective

Area of Science:

• Addiction Medicine
• Clinical Psychology
• Public Health

Background:

• Conventional opioid maintenance treatment (COMT) is a cornerstone in managing opioid dependence.
• Patient preference and satisfaction are crucial for treatment adherence and outcomes.
• Limited data exists on patient willingness to switch to heroin maintenance treatment (HMT).

Purpose of the Study:

• To investigate patient preference for heroin maintenance treatment (HMT) over conventional opioid maintenance treatment (COMT).
• To identify characteristics of patients who would prefer HMT.

Main Methods:

• An anonymous survey was conducted among patients receiving COMT in Berlin, Germany.
• The survey included 986 participants from psychiatric hospitals and physicians' practices licensed for COMT.
• Questionnaires assessed patient preference for HMT versus COMT.

Main Results:

• 40.9% of surveyed patients expressed a preference for HMT over COMT.
• Patients preferring HMT reported more detoxification attempts, higher methadone equivalent doses, and continued illicit drug use.
• These patients also reported less improvement in mental health and working abilities under COMT.

Conclusions:

• Patient perspectives suggest a significant minority would opt for HMT, particularly those with treatment resistance.
• Findings highlight potential gaps in COMT effectiveness for certain patient subgroups.
• The study complements clinical data by emphasizing patient-reported outcomes and preferences in opioid addiction treatment.