Abstract
Methadone maintenance treatment (MMT) is an evidence-based intervention for opioid use disorder (OUD). Despite its effectiveness, drug use during treatment and dropout are common. Most MMT outcome studies have ignored or examined few protective factors. This study examines protective factor predictors of two primary MMT outcomes, drug abstinence and treatment retention. Patients (N = 118) initiating MMT completed baseline surveys. Urine drug screen and retention data were extracted from medical records. We assessed protective factors organized across five domains (treatment history, opioid-related, intrapersonal, relational, and socioeconomic/community). Bivariate and multivariable linear regression analyses and a Cox proportional-hazards model were conducted. Opioid-related factors (change readiness, use-related consequences) best predicted outcomes. Some treatment history (prior, earlier engagement) and socioeconomic/community (past 30-day income) factors had a protective influence, whereas intrapersonal factors (gratitude, searching for meaning-in-life) produced mixed findings. One relational factor (emotional support) approached significance. Our findings highlight innovative approaches that may help improve MMT outcomes.
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Data Availability
Due to the nature of this research, participants did not agree for their data to be shared publicly. Therefore, data and materials are not available.
Notes
Three cases were removed from the dataset (n = 1, left before completing the study; n = 1, participated a second time; n = 1 enrolled 15 days after intake). After removals, the data set included a final sample of 118 patients.
Most clinic patients reside in impoverished neighborhoods near the clinic, are older, and of Black/African American race. A subset of patients reside in surrounding working-class communities, are younger, and of White race.
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We thank the clinic staff, Joseph Urbiel, Amanda Briskey, John Salvage, Lauren Notoriano, and Danielle Swantek for their assistance with recruitment and data collection.
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This work was supported by a research grant (to JJL) from the Wayne State University Provost and Vice President for Academic Affairs; Gertrude Levin Endowed Chair in Addiction and Pain Biology (MKG), Lycaki/Young Funds (State of Michigan); and Detroit Wayne Integrated Health Network. There are no associated grant numbers.
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JJL led writing, conceptualization, and methodology in this manuscript, acquired funding and served as principal investigator on the study, and provided supervision to JDE and CAS for data curation, statistical analyses, and visualization of statistical data. JDE contributed to writing, conceptualization, and methodology in this manuscript, curation of the data set, and analysis and visualization of statistical data. CAS contributed to statistical analyses, visualization of statistical data, and writing. DML was a co-investigator on the study and contributed to conceptualization and methodology in this submission, and provided reviews and editing on writing. MKG was a co-investigator on the study and contributed to conceptualization and methodology in this submission, provided reviews and editing on writing, and arranged resources (e.g., private research suite) for data collection.
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Lister, J.J., Ellis, J.D., Struble, C.A. et al. Protective Factor Predictors of Abstinence and Retention in Patients Receiving Methadone Treatment for Opioid Use Disorder. Int J Ment Health Addiction 22, 615–633 (2024). https://doi.org/10.1007/s11469-022-00893-z
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DOI: https://doi.org/10.1007/s11469-022-00893-z