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More than 50,000 patients in Ontario are currently taking methadone as a treatment for opioid addiction, but researchers at St. Joseph's Healthcare Hamilton and McMaster University have tested a questionnaire that successfully identifies patients who have a high risk of relapsing.

Identifying these patients allows clinicians to better address the problem of relapse by providing intensive treatment to patients at risk. It is estimated that the effectiveness of methadone treatment for reducing illicit opioid use is between 20% and 70%. The study results showed that the questionnaire had excellent retest reliability, and could accurately predicts patients’ illicit drug use for up to three months.

“In a time when the use of potent opioids such as fentanyl is on the rise, it is best that we take all precautions in clinician decision making,” said the study’s senior author Dr. Zena Samaan. She is an associate professor of psychiatry and behavioural neurosciences at McMaster University and a clinician and researcher at St. Joseph’s Healthcare Hamilton.

“The purpose of creating a tool to identify patients at high risk for relapse during methadone treatment is to not only prevent overdose but also to target therapies most appropriate for this patient population.”

Created by a research partnership between McMaster University’s Population Genomics program and the Canadian Addiction Treatment Centres (CATC), the tool is a questionnaire that analyses the addiction severity as well as patients’ treatment response to methadone.

“Identifying patients at high risk for relapse will serve as a strategy for treatment tailoring, relapse prevention, and altogether improving our understanding about managing opioid dependence,” said first author Dr. Brittany Dennis, a research affiliate at the Peter Boris Centre for Addictions Research at St. Joseph’s Healthcare Hamilton and McMaster University.

The latest Canadian Tobacco, Alcohol and Drugs Survey taken in 2013 found that 2% of Canadians reportedly abused opioids. The Canadian Centre on Substance Abuse reports that opioid-related deaths increased by over 240% between 1990 to 2010.

The study was published online in the International Journal of High Risk Behaviour & Addiction and was funded by the Canadian Institutes of Health Research, the Chanchlani Research Centre and the Peter Boris Centre for Addictions Research.

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