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Heroin Addiction and Related Clinical Problems: 2017, 19, N4 (pages: 35 - 40)

Exploring Predictors of Response to Methadone Maintenance Treatment for Heroin Addiction: The Role of Patient Satisfaction with Methadone as a Medication

Alcaraz S., Trujols J., Siñol N., Duran-Sindreu S., Batlle F., and Pérez de los Cobos J.

Summary: Background: Patients' degree of dissatisfaction with methadone is correlated with their response to methadone maintenance treatment (MMT), as patients who do not interrupt compulsive use of substances during MMT are less satisfied with methadone than their counterparts who do. Aim: To examine the satisfaction of heroin-dependent patients with methadone as an independent predictor of response to MMT. Methods: Participants (n = 185) were heroin-dependent patients who had been receiving MMT for at least the previous three months. Of these, 152 were considered non-responders due to current substance use disorders (SUD) requiring inpatient detoxification treatment, and 33 were considered responders due to sustained full remission of SUD. Satisfaction with methadone as a medication was measured with the Scale to Assess Satisfaction with Medications for Addiction Treatment – methadone for heroin addiction (SASMAT-METHER). The SASMAT-METHER subscales assess three domains: Personal Functioning and Well-Being; Anti-Addictive Effect on Heroin; and Anti-Addictive Effect on Other Substances (e.g., cocaine). We also evaluated other possible predictors of response to MMT: sociodemographic variables, heroin use, use of non-opioid substances, MMT characteristics and patients' views on methadone dose adjustment. Differences between non-responders and responders were tested individually; only those variables that reached statistical significance (p ≤ .05) were included in a subsequent binary logistic regression analysis. Results: On the regression model, two factors were independently associated with the likelihood of non-response to MMT: 1) a low level of satisfaction with the Anti-Addictive Effect (of methadone) on other substances and 2) current benzodiazepine treatment. Conclusions: Our results suggest that heroin-dependent patients' degree of satisfaction with methadone may be an independent predictor of MMT response. Prospective studies are now needed to confirm this finding.