Methadone Substitution Therapy among Opioid Dependents: A Unicentric Experience

Introduction Methadone substitution therapy aimed to improve the health and social performance of opioid-dependents. In view of the local scarcity of data with regards to the program effectiveness, we aimed to remedy this.   

Methodology This cross-sectional study involved data transcription from clinical records of active opioid dependents undergoing methadone substitution therapy for the year 2021 in Hospital Tuanku Fauziah, Perlis. Data collected include demographic variables, history of illicit drug use, trend in temporal modulation of methadone dosage, and co-use of illicit drugs. 

Results There were a total of 87 patients, all were male with the mean age of 43.9±8.33 years old. Majority had been diagnosed with Hepatitis C (n=54, 62.1%). Heroin was the most commonly abused substance prior to program enrolment (n=77, 88.5%), followed by kratom (n=45, 51.7%). For the past three years, majority of our patients had continued illicit drug use during the program (n=51, 58.6%) with the urine spot test in 2019 yielded the highest recorded positive tests (n=32, 36.8%). Methamphetamine and amphetamine co-use were the commonest (n=12, 37.5%). Hepatitis C status was neither associated with the current methadone dose, U=539.5, p=0.186, nor the highest dose required, t=-0.291, df=74, p=0.772. We did not identify any predictive factors to successful drug abstinence during methadone substitution program. There was also a poor correlation between methadone dose and retention rates, r=0.22, p=0.042.   

Discussion / Conclusion Studies looking into potential factors that influence treatment retention and opioid abstinence during methadone substitution program is needed to optimize national cost for healthcare.

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