|Titre :||Defining dosing pattern characteristics of successful tapers following methadone maintenance treatment: results from a population-based retrospective cohort study (2012)|
|Auteurs :||B. NOSYK ; H. SUN ; E. EVANS ; D. C. MARSH ; M. D. ANGLIN ; Y. I. HSER ; A. H. ANIS ; E. DAY, Auteur du commentaire|
|Type de document :||Article : Périodique|
|Dans :||Addiction (Vol.107, n°9, September 2012)|
|Article en page(s) :||1621-1629|
|Note générale :||Commentary: Detoxification from methadone maintenance therapy: how important is the exact technique that is used? Day E., p. 1630-1631.|
|Discipline :||TRA (Traitement et prise en charge / Treatment and care)|
Thésaurus TOXIBASEMETHADONE ; TRAITEMENT DE MAINTENANCE ; SUBSTITUTION ; ETUDE RETROSPECTIVE ; COHORTE ; POSOLOGIE ; REDUCTION DE CONSOMMATION
Aims: To identify dose-tapering strategies associated with sustained success following methadone maintenance treatment (MMT).
Design: Population-based retrospective cohort study.
Setting: Linked administrative medication dispensation data from British Columbia, Canada.
Participants: From 25 545 completed MMT episodes, 14 602 of which initiated a taper, 4183 individuals (accounting for 4917 MMT episodes) from 1996 to 2006 met study inclusion criteria.
Measurements: The primary outcome was sustained successful taper, defined as a daily dose ≤5 mg per day in the final week of the treatment episode and no treatment re-entry, opioid-related hospitalization or mortality within 18 months following episode completion.
Findings: The overall rate of sustained success was 13% among episodes meeting inclusion criteria (646 of 4917), 4.4% (646 of 14 602) among all episodes initiating a taper and 2.5% (646 of 25 545) among all completed episodes in the data set. The results of our multivariate logistic regression analyses suggested that longer tapers had substantially higher odds of success [12-52 weeks versus 52 weeks versus Conclusions: The majority of patients attempting to taper from methadone maintenance treatment will not succeed. Success is enhanced by gradual dose reductions interspersed with periods of stabilization. These results can inform the development of a more refined guideline for future clinical practice.
Very few patients who try to taper off from methadone maintenance treatment succeed. Success is more likely when patients combine tapering with periods of stable methadone use.
|Domaine :||Drogues illicites / Illicit drugs|
|Refs biblio. :||42|
|Affiliation :||BC Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada|