Abstract
Background
The methadone protocol placed responsibility on general practitioners (GPs) for the methadone treatment of stabilised drug-addicted patients. The protocol emphasised a medico-pharmacological model with minor reference to psychotherapeutic treatment.
Aim
This qualitative study investigated how primary care GPs in Ireland use psychotherapeutic interventions in the treatment of methadone patients.
Method
A grounded theory methodology was used.
Findings
There is a wide variation in the beliefs and knowledge of methadone-prescribing GPs regarding the efficacy of psychotherapeutic interventions for patients on methadone maintenance. GPs do not formally integrate psychotherapeutic interventions into methadone patient treatment. Accessing psychotherapeutic services raises concerns for GPs in terms of availability, location and quality. Primary care GPs who offer methadone maintenance view opiate abuse as a health issue similar to other such issues within their community. They take a holistic view of their methadone patient and, without formal guidelines, develop individual approaches to the use of psychotherapeutic interventions. The absence of a framework for the use of psychotherapeutic interventions in primary care methadone treatment in Ireland militates against the development of a basis for improving practice.
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References
Department of Health and Children Ireland, (1998) Report of the Methadone Treatment Services Review Group. Department of Health and Children, Dublin
Department of Health Ireland, (1993) Report of the Expert Group on the Establishment of a Protocol for the Prescribing of Methadone. Department of Health, Dublin
Salamina G, Diecidue R, Vigna-Taglianti F et al (2010) Effectiveness of therapies for heroin addiction in retaining patients in treatment: results from the VEdeTTE study. Subst Use Misuse 45(12):2076–2092. doi:10.3109/10826081003791932
Kraft M, Rothbard A, Hadley T, McLellan A, Asch D (1997) Are supplementary services provided during methadone maintenance really cost-effective? Am J Psychiatry 154(9):1214–1219
Creswell J (2005) Educational research: planning, conducting, and evaluating quantitative and qualitative research, 2nd ed edn. Merrill, Upper Saddle New Jersey
Glaser B, Strauss A (1967) The discovery of grounded research : strategies for qualitative research. Aldine Publishing, Chicago, p 1
Glaser B, Holton J (2004) Remodeling grounded theory. Forum: qualitative social research 5(2), Art. 4. http://www.qualitative-research.net/fqs-texte/2-04/2-04glaser-e.htm. Accessed 3 September 2007
Glaser B (1978) Theoretical Sensitivity. Sociology Press, California
Curran V, Drummond C Psychological treatments of substance misuse and dependence. Foresight Brain Science, Addiction and Drugs Project. http://www.bis.gov.uk/assets/bispartners/foresight/docs/brain-science/psychological-treatments.pdf
Amato L, Minozzi S, Davoli M, Vecchi S, Ferri M, Mayet S (2008) Psychosocial combined with agonist maintenance treatments versus agonist maintenance treatments alone for treatment of opioid dependence. Cochrane Database Syst Rev. doi:10.1002/14651858.CD004147.pub3
Fiorentine R, Anglin M (1997) Does increasing the opportunity for counseling increase the effectiveness of outpatient drug treatment? Am J Drug Alcohol Abuse 23(3):369–382
Gossop M, Stewart D, Marsden J (2003) Treatment process components and heroin use outcome among methadone patients. Drug Alcohol Depend 71(1):93–102. doi:10.1016/S0376-8716(03)00067-X
Woody G (2003) Research findings on psychotherapy of addictive disorders. Am J Addict 12(1):S19–S26. doi:10.1111/j.1521-0391.2003.tb00553.x
Scherbaum N, Kluwig J, Specka M, Krause D, Merget B, Finkbeiner T (2005) Group psychotherapy for opiate addicts in methadone maintenance treatment—a controlled trial. Eur Addict Res 11(4):163–171. doi:10.1159/000086397
von Sydow K, Schindler A, Beher S, Schweitzer-Rothers J, Retzlaff R (2010) The efficacy of systemic therapy for substance use disorders in adult and adolescent index patients Sucht: Zeitschrift für Wissenschaft und Praxis. Special issue: systems-oriented and family-based approaches in the treatment of addictive disorders 56(1):21–42. doi:10.1024/0939-5911/a000009
Veilleux JC, Colvin PJ, Anderson J, York C, Heinz AJ (2010) A review of opioid dependence treatment: pharmacological and psychosocial interventions to treat opioid addiction. Clin Psychol Rev 30(2):155–166. doi:10.1016/j.cpr.2009.10.006
Keenan E (2005) Irish addiction services—past, present and future. Ir J Psychol Med 22(4):118–120
Herman M, Gourevitch MN (1997) Integrating primary care and methadone maintenance treatment: implementation issues. J Addict Dis 16(1):91–102. doi:10.1300/J069v16n01_06
Ward J (2002) Justifying drug substitution therapies: the case of methadone maintenance treatment. In: 2nd annual conference of the addiction research centre. Trinity College, Dublin
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Kenny, K., O’Carroll, A. The use of psychotherapeutic interventions by primary care GPs in Ireland in the treatment of their methadone patients: a grounded theory study. Ir J Med Sci 181, 43–48 (2012). https://doi.org/10.1007/s11845-011-0745-x
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DOI: https://doi.org/10.1007/s11845-011-0745-x