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Interruption of medication-assisted treatment for opioid dependence: insights from the UK

Farrukh Alam (Clinical Director, based at Offender Care Services, Central & North West London NHS Foundation Trust, London, UK)
Peter Barker (Consultant, based at Public Health, Northamptonshire County Council, Northampton, UK)

Drugs and Alcohol Today

ISSN: 1745-9265

Article publication date: 26 August 2014

544

Abstract

Purpose

The purpose of this paper is to identify risk factors for interruptions in opioid dependence treatment and barriers to (re) entering effective treatment through real-world insight on current opioid dependence treatment in the UK.

Design/methodology/approach

Project Access UK, a national survey deployed across multiple regions in England, Wales and Scotland, collected data on the perspectives of patients receiving medication-assisted treatment (MAT) for opioid dependence (n=248), out-of-treatment opioid users (n=196), and physicians (n=100).

Findings

Both patients and users reported multiple prior episodes of MAT and detoxification. Among patients, 57 per cent reported continuing illicit drugs use in addition to their treatment, 25 per cent had misused (injected or snorted) and 30 per cent had diverted (sold or given away) prescribed opioid medications. Diverted medications were currently being used by 26 per cent of out-of-treatment users; of these, 21 per cent used methadone. Supervised dosing was rated as the condition of treatment with the biggest impact on daily life. Daily supervision was a requirement for 44, 34 and 23 per cent of patients receiving methadone, mono-buprenorphine and buprenorphine-naloxone, respectively.

Practical implications

Interruptions to opioid dependence treatment in various forms can hamper the recovery of opioid-dependent patients. The benefits of MAT may not be fully realised if treatment is interrupted due to compliance failure, or inflexible treatment programmes leading to premature treatment exit. These findings serve to highlight areas in which treatment disruption can potentially be addressed.

Originality/value

Consideration of these findings may aid in the optimisation of treatment delivery practices to better meet the UK policy of recovery, and ultimately improve patient outcomes.

Keywords

Acknowledgements

The original questionnaires were designed by Professor Heino Stöver. Financial support for implementation of the survey and medical writing of this manuscript was provided by Reckitt Benckiser Pharmaceuticals. The authors would like to thank all the participants (physicians, treatment centres and user support groups); the research collaborators/advisers, Chive Insight and Planning (for market-research consultancy); Synovate Healthcare (for market-research data collection). Medical writing support was provided by Meg Heaslop and Dr Nicola Booth at Real Science Communications. Both authors analysed and interpreted the data, contributed to the writing of the paper, and had full editorial control and final responsibility for the decision to submit the paper for publication.

Citation

Alam, F. and Barker, P. (2014), "Interruption of medication-assisted treatment for opioid dependence: insights from the UK", Drugs and Alcohol Today, Vol. 14 No. 3, pp. 114-125. https://doi.org/10.1108/DAT-01-2014-0002

Publisher

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Emerald Group Publishing Limited

Copyright © 2014, Emerald Group Publishing Limited

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