Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
Addiction Science & Clinical Practice
Published in: Addiction Science & Clinical Practice 1/2019

Open Access 01-12-2019 | Affective Disorder | Research

An evaluation of the maintenance to abstinence (MTA) program in achieving abstinence in opioid users and improving mental health and quality of life

Authors: Madeleine M. Southey, Trent Rees, Margaret Rolfe, Sabrina Pit

Published in: Addiction Science & Clinical Practice | Issue 1/2019

Login to get access

Abstract

Background

Residential opioid rehabilitation aims to improve the mental health and quality of life of opioid users through abstinence and residential program participation. This study aimed to determine the depression, anxiety, stress and quality of life amongst maintenance to abstinence (MTA) program residents. Secondary study aims were to assess the personal characteristics of MTA clients, addiction and risk taking behaviours, factors associated with program completion, as well as to assess the reliable change in participants’ mental health and quality of life on exit.

Methods

Retrospective analysis of routinely collected data (2013–2017) from surveys completed by 100 clients. Outcome measures were: Depression, Anxiety, Stress Score (DASS-42), World Health Organisation Quality of Life 8 questions (WHOQOL-8) and Kessler Psychological Distress Scale (K10). Other variables included demographics, drug use, other addictions, aggression, self-harm, suicidal ideation/attempts, and risk taking behaviours. Statistical methods included Chi-square, Fisher’s exact, t-tests, repeated measures analysis of variance and the Reliable Change Index.

Results

All mean DASS-42, WHOQOL-8 and K10 scores improved significantly in all participants from entry to exit (p < 0.001). The majority of participants demonstrated reliable improvement across all psychometric measures. Completion rates for the MTA program were 51%. Depression (p = 0.023), anxiety (p = 0.010) and stress (p = 0.015) DASS-42 scores decreased significantly more in completers compared to non-completers. The rate of improvement in mean WHOQOL-8 scores and psychological distress scores (K10) was not statistically significantly different between completers and non-completers over time. There was no significant difference between completers and non-completers on socio-demographics, self-reported drug addiction or risk taking behaviour on program entry, except for suicidal thoughts while intoxicated (p = 0.033). Completers were more satisfied with their relationships (p = 0.044) and living place (p = 0.040) on program entry.

Conclusion

Overall, completers and non-completers demonstrated improved mental health and quality of life from entry to exit, regardless of program completion. Depression, anxiety and stress reduced more markedly in program completers. Policy makers and programmers could use these findings to further validate their own programs to improve mental health and quality of life of opioid users.
Appendix
Available only for authorised users
Literature
1.
Bruneau J, Ahamad K, Goyer MÈ, Poulin G, Selby P, Fischer B, Wild TC, Wood E, CIHR Canadian Research Initiative in Substance Misuse. Management of opioid use disorders: a national clinical practice guideline. CMAJ. 2018;190(9):E247–57.CrossRef
2.
Chen T, Masson CL, Sorensen JL, Greenberg B. Residential treatment modifications: adjunctive services to accommodate clients on methadone. Am J Drug Alcohol Abuse. 2009;35(2):91–4.CrossRef
3.
Sorensen JL, Andrews S, Delucchi KL, Greenberg B, Guydish J, Masson CL, Shopshire M. Methadone patients in the therapeutic community: a test of equivalency. Drug Alcohol Depend. 2008;100(1–2):100–6.PubMedPubMedCentral
4.
Nunes E, Sullivan M, Levin F. Treatment of depression in patients with opiate dependence. Biol Psychiatry. 2004;56(10):7938802.CrossRef
5.
AIHW: Australian Institute of Health and Welfare. National Drug Strategy Household Survey detailed report: 2013. Drug statistics series no. 28. Cat. no. PHE 183. Canberra: AIHW; 2014.
6.
Johnson M, Neal D, Brems C, Fisher D. Depression among out-of-treatment injecting drug users as measured by the Beck Depression Inventory 82. Assessment. 2006;13(2):168–77.CrossRef
7.
Magidson J, Gorka S, MacPherson L, Hopko D, Blanco C, Lejuez C, Daughters S. Examining the effect of the life enhancement treatment for substance use (LETS ACT) on residential substance abuse treatment retention. Addict Behav. 2011;36(6):6158623.CrossRef
8.
Teesson M, Havard A, Fairbairn S, Ross J, Lynskey M, Darke S. Depression among entrants to treatment for heroin dependence in the Australian Treatment Outcome Study (ATOS): prevalence, correlates and treatment seeking. Drug Alcohol Depend. 2005;78:309–15.CrossRef
9.
Brunette M, Mueser K, Drake R. A review of research on residential programs for people with severe mental illness and co-occuring substance use disorders. Drug Alcohol Rev. 2004;23:471–81.CrossRef
10.
11.
12.
Collins D, Lapsley H. The costs of tobacco, alcohol and illicit drug abuse to Australian society in 2004/2005. National Drug Strategy Monograph series no. 66. Commonwealth Department of Health and Ageing, Canberra; 2008.
13.
Gossop M, Marsden J, Stewart D, Kidd T. The National Treatment Outcome Research Study (NTORS): 4–5 year follow-up results. Addiction. 2003;98(3):291–303.CrossRef
14.
Gossop M. The National Treatment Outcomes Research Study (NTORS) and its influence on addiction treatment policy in the United Kingdom. Addiction. 2015;110:50–3.CrossRef
15.
Turner B, Deane FP. Length of stay as a predictor of reliable change in psychological recovery and well-being following residential substance abuse treatment. Ther Communities. 2016;37(3):112–20.CrossRef
16.
De Leon G. The therapeutic community: theory, model, and method. New York: Springer; 2000.CrossRef
17.
Babaie E, Razeghi N. Comparing the effects of methadone maintenance treatment, therapeutic community, and residential rehabilitation on quality of life and mental health of drug addicts. Addict Health. 2013;5:16–20.PubMedPubMedCentral
18.
NSW Ministry of Health. NSW clinical guidelines: treatment of opioid dependence; 2018.
19.
20.
Lovibond S, Lovibond P. Manual for the Depression Anxiety Stress Scales. 2nd ed. Sydney: Psychology Foundation; 1995.
21.
22.
Kessler R, Andrews G, Colpe L, Hiripi E, Mroczek D, Normand S, Zaslavsky A. Short screening scales to monitor population prevalences and trends in non-specific psychological distress. Psychol Med. 2002;32(06):959–76.CrossRef
23.
Crawford J, Henry J. The Depression Anxiety Stress Scales (DASS): Normative data and latent structure in a large non-clinical sample. Br J Clin Psychol. 2003;2003(42):111–31.CrossRef
24.
Network of Alcohol and other drugs agencies (NADA). Using the Client Outcomes Management System (COMS), Network of alcohol and other drugs agencies, Strawberry Hills, Australia; 2012.
25.
26.
27.
IBM Corp. (Released 2016). IBM SPSS Statistics for Windows, Version 24.0. Armonk: IBM Corp.
28.
Christensen L, Mendoza J. A method of assessing change in a single subject: an alteration of the RC index. Behav Ther. 1986;12:305–8.CrossRef
29.
30.
31.
32.
NSW Department of Health. NSW health drug and alcohol psychosocial interventions professional practice guidelines; 2008.
33.
34.
Harley M, Pit S, Rees T, Thomas S. Completion Rates and psychosocial intervention effectiveness in an Australian substance abuse therapeutic community. Subst Abuse Treat Prev Policy. 2017;13:33.CrossRef
Metadata
Title
An evaluation of the maintenance to abstinence (MTA) program in achieving abstinence in opioid users and improving mental health and quality of life
Authors
Madeleine M. Southey
Trent Rees
Margaret Rolfe
Sabrina Pit
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Addiction Science & Clinical Practice / Issue 1/2019
Electronic ISSN: 1940-0640
DOI
https://doi.org/10.1186/s13722-019-0132-x

Other articles of this Issue 1/2019

Addiction Science & Clinical Practice 1/2019 Go to the issue

Research

Receipt of pharmacotherapy for alcohol use disorder by justice-involved women in the Veterans Health Administration

Case Report

How to overcome political and legal barriers to the implementation of a drug consumption room: an application of the policy agenda framework to the Belgian situation

Research

Electronic self-administered screening for substance use in adult primary care patients: feasibility and acceptability of the tobacco, alcohol, prescription medication, and other substance use (myTAPS) screening tool

Study protocol

Study protocol for a pragmatic trial of the Consult for Addiction Treatment and Care in Hospitals (CATCH) model for engaging patients in opioid use disorder treatment

Review

Priming primary care providers to engage in evidence-based discussions about cannabis with patients

Review

Strategies to increase implementation of pharmacotherapy for alcohol use disorders: a structured review of care delivery and implementation interventions