title: Evaluation of a low-threshold/high-tolerance methadone maintenance treatment clinic in saint john, new brunswick, Canada: one year retention rate and illicit drug use.
abstract: Objective. To report the one-year retention rate and the prevalence of illicit opioid use and cocaine use in the Low-Threshold/High-Tolerance (LTHT) methadone maintenance treatment (MMT) clinic located in Saint John, New Brunswick, Canada. Methods. A description of the LTHT MMT clinic is provided. The one-year retention rate was determined by collecting data on patients who enrolled in the LTHT MMT clinic between August 04, 2009 and August 04, 2010. The prevalence of illicit drug use was determined using a randomly selected retrospective cohort of 84 participants. For each participant the results of six consecutive urine tests for the most recent three months were compared to the results of the first six consecutive urine tests after program entry. Results. The one-year retention rate was 95%, 67% of the cohort achieved abstinence from illicit opioids and an additional 13% abstained from cocaine use. Conclusion. The novel feature of the LTHT MMT clinic is that patients are not denied methadone because of lack of ancillary services. Traditional comprehensive MMT programs invest the majority of financial resources in ancillary services that support the biopsychosocial model, whereas the LTHT approach utilizes a medical model and directs resources at medical management.
authors.affiliation: Ethics Services, Horizon Health Network, Miramichi, NB, Canada, E1V 1Y3 ; Department of Bioethics, Dalhousie University, Halifax, NS, Canada, B3K 6R8.
authors.forename: Timothy K S
authors.initials: TK
authors.lastname: Christie
authors.affiliation: Ethics Services, Horizon Health Network, Miramichi, NB, Canada, E1V 1Y3 ; Dr. Reiman's Cancer Research Laboratory, University of New Brunswick, Saint John, NB, Canada, E3B 5A3.
authors.forename: Alli
authors.initials: A
authors.lastname: Murugesan
authors.affiliation: Uptown Clinic, St. Joseph's Hospital, Saint John, NB, Canada, E2L 3L6.
authors.forename: Dana
authors.initials: D
authors.lastname: Manzer
authors.affiliation: British Columbia Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada, V6Z 1Y6.
authors.forename: Michael V
authors.initials: MV
authors.lastname: O'Shaughnessey
authors.affiliation: Department of Medicine, Saint John Regional Hospital, Saint John, NB, Canada, E2L 3L6.
authors.forename: Duncan
authors.initials: D
authors.lastname: Webster