title: Characteristics and outcome of minority group patients in methadone maintenance treatment.
abstract: Abstract Minority status is associated with mental and physical morbidity, substance dependence, and poor outcomes. To compare characteristics and treatment outcomes between patients from two minority groups in Israel (Christians and Muslims) and patients from the majority population (Jews) in methadone maintenance treatment (MMT), we prospectively studied all patients admitted to our clinic between 1993 and 2012 and followed up until 2013; 655 Jews, 67 Christians, and 37 Muslims. Christian patients differed from Jews and Muslims by younger age at admission to MMT, greater prevalence of drug injectors, and a higher proportion of Hepatitis-C and HIV sera positive. Muslims had comparatively less education and a lower proportion of females. The three groups had similar rates of one-year retention (75.9%) and opiate abstinence (68.1%). They also did not differ in long-term retention (up to 20 years): Muslims 5.5 years (95%CI 3.6-7.4), Christians 7.5 years (95%CI 6-9.1), and Jews 7.6 years (95%CI 7-8.2, p = .3). The Hepatitis-C incidence, however, was higher among the 21 admitted Hepatitis-C seronegative minorities (5.0/100 person years) than the 207 Hepatitis-C seronegative non-minority patients (1.7/100 person years, p=0.03). All groups had good treatment outcomes, except for Hepatitis-C seroconversion, which necessitates a specific preventive intervention among the minority groups.
authors.affiliation: a Epidemiologist, The Dr. Miriam and Sheldon G. Adelson Clinic for Drug Abuse Treatment and Research, Tel Aviv Sourasky Medical Center; Sackler Faculty of Medicine , Tel Aviv University , Tel Aviv , Israel.
authors.forename: Einat
authors.initials: E
authors.lastname: Peles
authors.forename: Shaul
authors.initials: S
authors.lastname: Schreiber
authors.forename: Miriam
authors.initials: M
authors.lastname: Adelson
mesh_terms: D000293:Adolescent; D000328:Adult; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D016009:Chi-Square Distribution; D002835:Christianity; D055030:Drug Users; D005260:Female; D006526:Hepatitis C / Q000208:ethnology; D006801:Humans; D015994:Incidence; D007514:Islam; D007557:Israel; D007585:Jews; D007599:Judaism; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D008913:Minority Groups; D054525:Minority Health; D015999:Multivariate Analysis; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000175:diagnosis / Q000208:ethnology / Q000534:rehabilitation*; D011446:Prospective Studies; D012008:Recurrence; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
keywords: Hepatitis C; methadone maintenance treatment; minority; retention; sero-conversion