Cannabis abuse is not a risk factor for treatment outcome in methadone maintenance treatment: a 1-year prospective study in an Israeli clinic.
OBJECTIVE
We addressed the following questions. What are the current and lifetime prevalence of cannabis abuse in an Israeli methadone maintenance treatment (MMT) clinic? Does cannabis abuse change over time during MMT? Is cannabis abuse related to treatment outcome measures such as retention rate and the abuse of drugs? Is the abuse of cannabis related to psychopathology, HIV/HCV risk-taking and infectious diseases? Do cannabis abusers (CAs) have a different psychosocial and demographic profile than nonabusers (NCAs)? Is cannabis abuse part of a polydrug abuse tendency or a distinct substance of abuse?


METHODS
Overlapping samples of either the entire clinic population (n = 283) or all the patients who had completed 1 year of MMT treatment (n = 196 of which 20 were re-entering) underwent random and twice-weekly observed urine analysis for various drugs of abuse, responded to self-report questionnaires (SCL-90-R; HIV/HCV risk-taking behaviours; n = 164), interviews (ASI, n = 176; SCID, n = 151) and hepatitis C and HIV testing (n = 149).


RESULTS
Lifetime abuse prevalence was found in 75% and current abuse at MMT intake in 25%. Abuse did not increase significantly over a 1-year period. Cannabis abusers were found to be more often polydrug abusers than NCAs. Cannabis abusers did not suffer from more psychological distress, infectious diseases, and did not engage in more HCV/HIV risk-taking behaviour, nor did they leave treatment earlier than NCAs.


CONCLUSIONS
Cannabis abuse MMT patients should be treated as polydrug abusers, although no specific influences of cannabis abuse on psychological and medical conditions of MMT patients have been observed. Treatment policy should take these results into consideration.
Weizman
Tal
T
Psychiatric Service, Tel Aviv Sourasky Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
Gelkopf
Marc
M
Melamed
Yuval
Y
Adelson
Miriam
M
Bleich
Avraham
A
D000328:Adult; D000553:Ambulatory Care; D015897:Comorbidity; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D013287:Illicit Drugs; D007557:Israel; D008297:Male; D002189:Marijuana Abuse / Q000453:epidemiology* / Q000534:rehabilitation; D001523:Mental Disorders / Q000453:epidemiology / Q000534:rehabilitation; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D016485:Needle Sharing; D009293:Opioid-Related Disorders / Q000453:epidemiology* / Q000534:rehabilitation*; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data; D010359:Patient Readmission / Q000706:statistics & numerical data; D012047:Rehabilitation Centers; D012307:Risk Factors; D012309:Risk-Taking; D021841:Safe Sex; D015813:Substance Abuse Detection; D019966:Substance-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation
D013287:Illicit Drugs; D009294:Narcotics; D008691:Methadone