title: Effectiveness of Methadone Maintenance Therapy and Improvement in Quality of Life Following a Decade of Implementation.
abstract: Methadone maintenance therapy has been found to be an effective harm reduction treatment for opioid use disorder. However evidence of its benefits over a longer duration of treatment is limited as most studies focus on its short term benefits. As methadone maintenance therapy reaches a decade since its implementation in Malaysia, this study sought to examine the effectiveness of methadone treatment, change in quality of life among patients since entry to methadone treatment, as well as factors predicting the magnitude of change in quality of life. This study found that methadone maintenance therapy was effective in reducing heroin use, injecting practices and crime, and in improving in social functioning and physical symptoms, but not in reducing sex-related HIV risk-taking behavior. Though patients had a significantly better quality of life at follow-up than at entry to methadone maintenance therapy, the improvement in quality of life was not significantly greater as the duration of treatment increased. Age above 50 years old, human immunodeficiency virus (HIV) positive status and physical symptoms predicted a poorer improvement in quality of life between baseline and follow-up. On the other hand, patients with hepatitis B showed a greater improvement in quality of life in the social relationships domain compared to patients without hepatitis B. In conclusion, methadone maintenance therapy is an effective treatment for opioid use disorder and improves quality of life but its benefits in further improving quality of life beyond a decade of treatment need further evaluation.
authors: Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia. Electronic address: drjoniteoh@gmail.com.
authors: Joni
authors: J
authors: Teoh Bing Fei
authors: University Malaya Centre for Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia.
authors: Anne
authors: A
authors: Yee
authors: University Malaya Centre for Addiction Sciences, University of Malaya, Kuala Lumpur, Malaysia.
authors: Mohamad Hussain Bin
authors: MH
authors: Habil
authors: Unit for the Enhancement of Academic Performance, University of Malaya, Kuala Lumpur, Malaysia.
authors: Mahmoud
authors: M
authors: Danaee
mesh_terms: D000328:Adult; D005500:Follow-Up Studies; D015658:HIV Infections / Q000453:epidemiology; D006509:Hepatitis B / Q000453:epidemiology; D006556:Heroin Dependence / Q000534:rehabilitation; D006801:Humans; D007398:Interpersonal Relations; D008296:Malaysia; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D058850:Opiate Substitution Treatment / Q000379:methods*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011788:Quality of Life; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000534:rehabilitation; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D008691:Methadone
keywords: Effectiveness; HIV; Methadone; Opioid use disorder; Quality of life