Wie effektiv sind Methadonbehandlungen in Privatpraxen∋

Summary: Objectives:Involvement of private practitioners in methadone maintenance treatment (MMT) enhances its availability. However, effectiveness of such treatments is still debated. Methods:A retrospective case register analysis comparing the retention of private practices with that of specialised institutions. All methadone maintenance treatment starting between January 1, 1997 and December 31, 1999. Kaplan-Meier survival estimates to test for different retention times; Cox-regression procedure to control for baseline differences between the two populations. Results:Even after controlling for distinct patient characteristics, MMT by private practitioners resulted in a longer retention time. Conclusions:Our findings favour the involvement of private practitioners. Providing better professional and financial support may enhance their participatio

CANNABIS USE AMONG A SAMPLE OF 16 TO 18 YEAR-OLD STUDENTS IN SWITZERLAND

Background: The aim of this study was to estimate the prevalence of cannabis use among Swiss students and to assess their attitudes regarding health and safety issues associated with drug use. Subjects and methods: After a workshop, 173 students (23.1% male, 75.7% female; 44.4% age 16, 43.8% age 17 and 11.8% age 18) from a Swiss school were surveyed by questionnaire. Results: 59.3% (n=103) of all participants had tried cannabis, and 30.1% of those who reported cannabis use had consumed more than 100 joints. Of those 103 students with cannabis experience, 6.8% rated the risk of cannabis-related psychic effects as low, and 9.8% were not concerned about driving under the influence of cannabis. In cases of heavy cannabis use, the chance of increased tobacco, alcohol or other drug use is higher than for those with less or no cannabis use at all (odds ratios of 4.33-10.86). Conclusions: This paper deals primarily with cannabis prevalence data in adolescents from previous studies and sources, and shows that our findings deviate significantly - and surprisingly - from past research. Our data from a school survey indicates higher cannabis use than data from official drug policy studies. Additionally, our data shows that the students’ self-reported attitudes towards health and safety issues were mostly realistic. The examination of methodological issues that might impact prevalence estimates should be added to the cannabis literature

There is no age limit for methadone: a retrospective cohort study

BACKGROUND: Data from the US indicates that methadone-maintained populations are aging, with an increase of patients aged 50 or older. Data from European methadone populations is sparse. This retrospective cohort study sought to evaluate the age trends and related developments in the methadone population of Basel-City, Switzerland. METHODS: The study included methadone patients between April 1, 1995 and March 31, 2003. Anonymized data was taken from the methadone register of Basel-City. For analysis of age distributions, patient samples were split into four age categories from '20-29 years' to '50 years and over'. Cross-sectional comparisons were performed using patient samples of 1996 and 2003. RESULTS: Analysis showed a significant increase in older patients between 1996 and 2003 (p < 0.001). During that period, the percentage of patients aged 50 and over rose almost tenfold, while the proportion of patients aged under 30 dropped significantly from 52.8% to 12.3%. The average methadone dose (p < 0.001) and the 1-year retention rate (p < 0.001) also increased significantly. CONCLUSIONS: Findings point to clear trends in aging of methadone patients in Basel-City which are comparable, although less pronounced, to developments among US methadone populations. Many unanswered questions on medical, psychosocial and health economic consequences remain as the needs of older patients have not yet been evaluated extensively. However, older methadone patients, just as any other patients, should be accorded treatment appropriate to their medical condition and needs. Particular attention should be paid to adequate solutions for persons in need of care

A pilot randomized trial of exercise as adjunct therapy in a heroin-assisted treatment setting

Background: Although the potential of exercise as an adjunct treatment for substance dependence is persuasive in theory, few controlled trials have assessed its effectiveness. Existing research has also largely focused on individuals aiming towards, or having already achieved, abstinence. This study employed a randomized design in a pilot trial to assess the feasibility, acceptance, and effects of an exercise intervention for individuals receiving outpatient heroin-assisted treatment. Method: 50 individuals receiving heroin-assisted treatment at a clinic in Switzerland were invited to take part in the trial. Participants were randomized to 12 weeks of exercise twice per week, or a corresponding duration of non-exercise group activities in a comparison condition. Data on attendance, compliance, and numerous psychological and physiological parameters were gathered. Results: 24 individuals were willing to take part in the study. 92.3% of the exercise condition (n = 13) were compliant or semi-compliant with the protocol; by contrast, only 54.6% of participants in the comparison condition (n = 11) were compliant or semi-compliant (χ2 = 7.049; p = 0.029). Participants in the exercise condition significantly increased the number of minutes spent exercising at a high intensity level (F(2,44) = 3.794; p = 0.046; η2 = 0.159). No other significant interaction effects were observed. Conclusions: An exercise intervention is a feasible and accepted supplementary therapy to heroin-assisted treatment. Participation rates were high, particularly given the outpatient setting. No evidence regarding the potential mechanisms of exercise as a therapy modality could be identified. Patients in heroin-assisted treatment may require a longer-term exercise programme, specifically targeting particular health parameters, before measurable improvements can be observed

Wie effektiv sind Methadonbehandlungen in Privatpraxen?

Summary: Objectives:Involvement of private practitioners in methadone maintenance treatment (MMT) enhances its availability. However, effectiveness of such treatments is still debated. Methods:A retrospective case register analysis comparing the retention of private practices with that of specialised institutions. All methadone maintenance treatment starting between January 1, 1997 and December 31, 1999. Kaplan-Meier survival estimates to test for different retention times; Cox-regression procedure to control for baseline differences between the two populations. Results:Even after controlling for distinct patient characteristics, MMT by private practitioners resulted in a longer retention time. Conclusions:Our findings favour the involvement of private practitioners. Providing better professional and financial support may enhance their participatio

Mental health among opiate users in Kabul – a pilot study from the medecins du monde harm reduction programme

The number of injecting opiate users in Afghanistan has recently risen dramatically. Through this cross-sectional pilot study, the authors have aimed to assess psychiatric comorbidity and drug use patterns among Afghan opiate users, which might have implications for harm reduction and treatment interventions. The authors conducted semi-structured psychiatric interviews, with a convenience sample of 30 clients of the Médecins du Monde drop-in centre in Kabul. Symptoms were classified according to the WHO International Classification of Diseases, Revision 10. Results show that psychiatric comorbidity is very common, particularly depressive and posttraumatic stress disorders. Ideally, this could be addressed by harm reduction and treatment measures