The impact of methadone substitution therapy (MST) on illicit drug use and drug abuse-related quality of life: a European study (2003)

Context: Although methadone substitution therapy (MST) is one of the most commonly used treatments for opiate dependence, legitimate questions continue to be raised about its effectiveness. Objective: To evaluate the impact of MST on illicit drug use and drug abuse-related quality of life (QoL). Design: Multicentre, cross-sectional case control study. Setting: Eleven MST programmes in eight European countries. Participants: Heroin dependent patients in MST programmes. Main outcome measures: Data on illicit drug use in the last month and injecting behaviour was extracted from the patient's substance use profile derived from EuroSUD as part of intake and ongoing assessment. The Brief Addiction Recovery Status Scale (EuroSAAQ-BARSS). Results: In Treatment (IT) groups reported a significantly lower number of illicit drugs used in the last month than controls (IT1: t = -6.81, p <.00001; IT2: t = -7.61, p <.00001; IT3: t = -6.32, p <.00001; IT4: t = -10.14, p <.00001). IT patients reported significantly lower rates of injecting than controls IT1 (OR = 0.48, 95%CI = 0.24, 0.95), IT2 (OR = 0.21, 95%CI = 0.12, 0.37), IT3 (OR = 0.43, 95%CI = 0.22, 0.87) and IT4 (OR = 0.27, 95%CI = 0.13, 0.57). They also expressed better drug-abuse related QoL for those patients who had been in treatment for at least 7 months (IT2: t = 4.43, p <.00001; IT3: t = 4.52, p <.00001; IT4: t = 6.22, p <.00001). Furthermore, there was a consistently positive relationship between duration in treatment and QoL scores. Conclusions: MST impacts positively on illicit drug use, injecting and drug abuse-related QoL. MST has been demonstrated as a culture-free and ecologically valid treatment modality for opiate dependence. (Authors abstract)