Only limited information on the process of completing long-term opiate substitution treatment
(OST) with substances like methadone exist. Furthermore, systematic knowledge from scientific
studies is scarce, there are only few studies with respect to treatment completion or regular
termination (mainly catamnestic analyses). Studies by Nordt et al. (2004) or Nordt & Stohler
(2006) show an estimated rate of 10% of patients per year who terminate OST by means of
tapering the substitution agent or changing into withdrawal treatment in specialized clinics.
It is state of the art that an indication for termination of OST has to be based on a common
agreement between the patient and the doctor. Furthermore, the patient should live in a
stable social situation and the state of health had markedly improved. Finally, the patient
has to be free of (illegal) drug use for at least 6 months and the individual aims of
treatment should have been reached (Vader et al. 2003).
The main objective of the prospective and explorative study is the systematic description of
the process of termination of OST. With a comparison between patients who complete OST
regularly and patients who terminate treatment prematurely (or are still in treatment)
predictors of positive termination of OST can be identified.
Patients treated with methadone or levomethadone of 5 general practitioners' practices and 2
specialized clinics who might be able to terminate OST during the next 12 months from the
doctors' perspective can take part in the study. In addition to baseline examination further
assessments take place every 3 months (i.e. after 3, 6, 9 and 12 months). The questionnaires
include state of health, well-being, social situation as well as drug and alcohol use.
Furthermore, the treating doctors are asked every 3 months to fill out questionnaires on
infections and other disorders, clinical characteristics, dosage process and drug use
(measured by urine samples).
Patients who will be successful in completing OST during the observational period will be
compared with the remaining cases.
Finally, a 6-month follow-up is planned in order to investigate the stability and maintenance
of the situation at month 12.
Details
Lead Sponsor:
Universitätsklinikum Hamburg-Eppendorf
Collaborators:
Asklepios Kliniken Hamburg GmbH Dr. Jochen Brack Dr. Rainer Ullmann Dr. Sibylle Quellhorst Gesine Hoeft Michael Klemperer