Trends in methadone maintenance treatment participation, retention, and compliance to dosing guidelines in British Columbia, Canada: 1996–2006

• Published in: Journal of substance abuse treatment Vol. 39; no. 1; pp. 22 - 31
• Main Authors: Nosyk, Bohdan, M.A, Marsh, David C., M.D., C.C.S.A.M, Sun, Huiying, Ph.D, Schechter, Martin T., M.D., Ph.D., F.R.C.P.C, Anis, Aslam H., Ph.D
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.07.2010; Elsevier; Elsevier Limited
• Subjects: Addictive behaviors; Adult; Adult and adolescent clinical studies; Biological and medical sciences; British Columbia; Canada; Compliance; Databases, Factual; Desintoxication. Drug withdrawal; Dosage; Dose-Response Relationship, Drug; Dosing guidelines; Drug addiction; Drug dosages; Female; Guideline Adherence - trends; Humans; Male; Medical sciences; Methadone; Methadone - administration & dosage; Methadone - therapeutic use; Methadone maintenance treatment; Middle Aged; Miscellaneous; Narcotics - administration & dosage; Narcotics - therapeutic use; Opioid dependence; Opioid-Related Disorders - rehabilitation; Practice Guidelines as Topic; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Public health. Hygiene; Public health. Hygiene-occupational medicine; Retention; Safety; Studies; Substance abuse treatment; Time Factors; Treatments; Trends; Young Adult; Canada; British Columbia; North America; America; British Columbia Canada; Dosing guidelines; Opioid dependence; Methadone maintenance treatment; Human; Participation; Drug addiction; Replacement therapy; Treatment efficiency; Trend; Opiates; Methadone; Narcotic analgesic; Posology; Recommendation; Maintenance treatment; Dependence; Treatment compliance; Public health
• ISSN: 0740-5472; 1873-6483
• DOI: 10.1016/j.jsat.2010.03.008

Abstract Aspects of methadone maintenance treatment (MMT) delivery, particularly daily dosing practices, are associated with longer retention in treatment. Our objective was to identify trends in compliance to MMT dosing guidelines at the population level in British Columbia, Canada, from 1996 to 2006. Analysis of a provincial drug dispensation database identified 31,724 MMT episodes initiated during the study period. The number of patients in treatment increased from 2,827 in 1996 to 9,601 in 2006. Long-term retention (>36 months) was achieved in 20%–25% of all episodes. Compliance to minimally effective dose guidelines, which is independently associated with retention, fell from 2001 to 2006. Accordingly, this decline was mirrored by 12-month retention figures, which fell from 45.9% in 2001 to 40.5% in 2005. Our evaluation has both highlighted the successes of the British Columbia Methadone program and identified aspects that may be improved to ensure safety and maximize the benefits of MMT.