Abstract
Background
The objective was to study substance abuse, infectious disease, and patient outcomes (retention and substance abuse abstinence) over 2 decades in a large methadone maintenance treatment (MMT) facility within a tertiary-referral medical center.
Methods
Prevalence of substance abuse was determined monthly between 1993 (35 patients) and 2013 (350 patients) based on observed random urine tests. On entry, patients were tested for hepatitis C and human immunodeficiency virus (HIV) antibodies. One-year retention and substance abuse abstinence were calculated.
Results
At admission, mean age and rate of cocaine and benzodiazepines abuse increased over the years, with no change in the prevalence of hepatitis C (50%) and HIV (<10%). Retention rate increased (P = .008) (range: 42.9%–92.4%; overall: 76.2%) and opiate abstinence also increased (P = .006) (range: 49.1%–85.7%; overall: 68.1%), reflecting outcome improvement over the years.
Conclusions
Outcome improvement could be attributed to the staff's growing experience and improvements in treatment but also to changes in patient characteristics over the past 2 decades.
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