Retention och prediktorer för behandlingsresultat vid läkemedelsassisterad behandling av opiatberoende

Background: Heroin addiction is a chronic relapsing illness associated with high mortality. Drug assisted maintenance treatment (MT) with methadone or buprenorphine is evidence-based and effective. Recently a new outpatient MT program, with fast access to treatment, was started in Malmö, Sweden. Aim: The aim of the study was to investigate 1-year retention in MT for opiate dependence in an outpatient setting and analyze potential predictors for treatment results, in terms of drug-free urine samples. Methods: Designed as a retrospective study carried out in an outpatient clinic. The participants started treatment between November 1st 2010 and February 16th 2012. 53 out of 72 patients could be contacted and consented to the study. 37 of these had started their treatment at the clinic and had completed more than a month of treatment at the time of the study. The latter group was included. Information was obtained through an interview and collected from the patient’s chart. Proportions of clean urine samples day 1-30, 31-90, 91-180, 181-270, 271-360 and potential predictors of drug- free outcome were analyzed. Results: The 1-year retention was 91 %. There were fewer overdoses amongst patients who had previously been in MT (p=0.039). Patients free from illicit opiates before the start of MT were more likely to be free from illicit opiates during day 1-30 and day 31-90 in MT (p=0.001 and p=0.046 respectively). Conclusion: The 1-year retention was, as shown in previous Swedish studies, high. We found that opiate abstinence before MT is a predictor of early treatment results. Overdoses were more common amongst patients who had not previously been subject to MT. It could be argued that more opiate addicts should be offered treatment