Meaning and methadone: Patient perceptions of methadone dose and a model to promote adherence to maintenance treatment
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Publication Details
Output type: Journal article
Author list: Sanders J., Roose R., Lubrano M., Lucan S.
Publisher: Lippincott, Williams & Wilkins
Publication year: 2013
Journal: Journal of Addiction Medicine (1932-0620)
Volume number: 7
Issue number: 5
Start page: 307
End page: 313
Number of pages: 7
ISSN: 1932-0620
eISSN: 1935-3227
URL: http://api.elsevier.com/content/abstract/scopus_id:84887866560
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Open access status: closed
Abstract
Objectives: Methadone maintenance treatment (MMT) effectively reduces illicit opioid use and its negative consequences when patients participate in and adhere to treatment. Patients' participation and adherence may relate to their perceptions about methadone doses and dose adjustments and the meanings that patients associate with treatment. This study assessed patient perceptions about methadone dosing and the meanings associated with methadone treatment to better support patient adherence to and success in MMT. Methods: We conducted semistructured interviews with 19 patients in an urbanMMTprogram. Interviews were transcribed verbatim and analyzed through an iterative process. Results: Participants' expressed perceptions about methadone doses related to ideas of "comfort" and "function," suggesting a model for determining dose appropriateness and "ideal" methadone dose based on various factors both intrinsic and extrinsic to MMT. Intrinsic factors included those exerting downward pressure on "ideal" methadone dose such as lack of control in treatment, disdain for getting "high," concerns about methadone dependence, and desire to avoid adverse effects; those exerting upward pressure such as concern about withdrawal; and those exerting mixed pressures such as methadone formulations. Extrinsic factors included those exerting downward pressure such as shame about and stigma around MMT; those exerting upward pressure such as medical conditions and medication interactions; and those exertingmixed pressures such as family and peer relationships. Conclusions: Participants held perceptions about methadone dosing that included considerations beyond typical medical parameters used by physicians and other MMT providers to determine appropriate methadone doses. The model that emerged from our data could help inform MMT providers to support greater patient comfort with methadone doses and dose changes, as well as adherence to and success in MMT. © 2013 American Society of Addiction Medicine.
Keywords
Methadone, Methadone dose, Methadone maintenance treatment, Opioid dependence, Patient-centered, Substance abuse
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