Determinants of methadone treatment assignment among heroin addicts on first admission to public treatment centres in Italy.
OBJECTIVE
To identify factors associated with entering any methadone treatment at first admission at an NHS treatment centre in Italy and to investigate determinants of receiving detoxification or maintenance methadone treatments.


METHODS
Data were analysed from 565 heroin addicts who entered for the first time one of 90 NHS treatment centres in 12 Italian regions between September 1998 and March 2001. Subjects were interviewed at admission by the centre's staff and followed-up for 18 months. Details on treatments provided were recorded using a standardised form. Random effects logistic regression analysis was applied.


RESULTS
Factors positively associated with any methadone treatment assignment were: being younger than 25 years and using heroin more than twice a day, having been recently incarcerated, and living with a partner. Independent predictors of admission to methadone maintenance were injecting heroin, having sex without a condom in the previous six months, being HIV positive and having been enrolled at a NHS TC where a psychiatrist was present. Using heroin once a day or more and using cocaine were factors associated with enrollment into detoxification treatment. A significant heterogeneity between centres was observed.


CONCLUSIONS
Results from this study give an insight into different patient profiles who are enrolled in methadone treatments. The observed heterogeneity between centres indicates the need to develop and implement common guidelines for the access of heroin addicts to substitution treatment.
Department of Epidemiology, ASL Rome E, Via di S. Costanza 53, 00198 Rome, Italy. bargagli@asplazio.it
Anna Maria
AM
Bargagli
Patrizia
P
Schifano
Marina
M
Davoli
Fabrizio
F
Faggiano
Carlo A
CA
Perucci
D000328:Adult; D000367:Age Factors; D005260:Female; D015658:HIV Infections / Q000635:transmission; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000523:psychology / Q000628:therapy*; D010342:Patient Acceptance of Health Care; D010343:Patient Admission; D011329:Prisoners; D016320:Substance Abuse Treatment Centers; D015819:Substance Abuse, Intravenous / Q000453:epidemiology / Q000523:psychology / Q000628:therapy*
D009294:Narcotics; D008691:Methadone