Dosis de metadona y su relación con calidad de vida, satisfacción, psicopatología, rendimiento cognitivo y consumo adicional de sustancias no prescritas

Eduardo J. Pedrero-Pérez, Grupo MethaQoL

Resumen


La efectividad de los tratamientos con metadona está fuera de toda duda, si bien persisten dudas sobre las dosis efectivas y los objetivos que debe perseguir un programa de mantenimiento. Algunos autores propugnan que sólo superiores a 50-60 mg/día deben ser consideradas efectivas, al bloquear los receptores opioides. Otros proponen dosis ajustadas a las necesidades del paciente, atendiendo prioritariamente a su recuperación. Se estudió una muestra representativa de todos los pacientes en tratamiento con agonistas del Instituto de Adicciones de Madrid (N=1898, n=450) y de la Junta de Extremadura (N=100, n=65). Se evaluaron calidad de vida, satisfacción con el tratamiento, sintomatología psicopatológica, rendimiento cognitivo y consumos adicionales. Los resultados muestran una relación negativa entre dosis y calidad de vida, sintomatología psicopatológica y rendimiento cognitivo. La satisfacción con el tratamiento, basado en dosis negociadas entre médico y paciente, fue muy elevada, con independencia de la dosis. Se formuló una ecuación estructural que relacionara todas las variables. Los resultados descartan la necesidad de utilizar dosis altas si el paciente no las precisa, y contar con otras intervenciones psicosociales que favorezcan la recuperación frente a la cronificación que supone el uso de dosis altas. Mientras los programas de altas dosis atienden prioritariamente a indicadores de control social, la calidad de vida del paciente debe ser uno de los principales indicadores de éxito del tratamiento, como en cualquier otro problema de salud.

 


Palabras clave


Mantenimiento con metadona; Dosis; Calidad de vida; Adicción; Tratamiento.

Texto completo:

PDF PDF (English)

Referencias


Adelson, M., Wilson, H. W., Celeste, V. Y., Linzy, S., Kreek, M. J. y Peles, E. (2013). Methadone maintenance treatment experience in Macao. Prospective follow-up for initial 4.5 years. Journal of Psychoactive Drugs, 45, 313-321. doi:10.1080/02791072.2013.825032

Al-Tayyib, A. y Koester, S. (2011). Injection drug users’ experience with and attitudes toward methadone clinics in Denver, CO. Journal of Substance Abuse Treatment, 41, 30–36. doi:10.1016/j.jsat.2011.01.009

Amato, L., Davoli, M., Perucci, C. A., Ferri, M., Faggiano, F. y Mattick, R. P. (2005). An overview of systematic reviews of the effectiveness of opiate maintenance therapies: available evidence to inform clinical practice and research. Journal of Substance Abuse Ttreatment, 28, 321-329. doi:10.1016/j.jsat.2005.02.007

Banys, P., Tusel, D. J., Sees, K. L., Reilly, P. M. y Delucchi, K. L. (1994). Low (40 mg) versus high (80 mg) dose methadone in a 180-day heroin detoxification program. Journal of Substance Abuse Treatment, 11, 225-232. doi:10.1016/0740-5472(94)90079-5

Baumeister, M., Vogel, M., Dürsteler-MacFarland, K. M., Gerhard, U., Strasser, J., Walter, M., ... Petitjean, S. A. (2014). Association between methadone dose and concomitant cocaine use in methadone maintenance treatment: a register-based study. Substance Abuse Treatment, Prevention, and Policy, 9, 46. doi:10.1186/1747-597X-9-46

Benyamin, R, Trescot, A. M., Datta, S., Buenaventura, R., Adlaka, R., Sehgal, N., … Vallejo, R. (2008). Opioid complications and side effects. Pain Physician, 11, S105-S120.

Bell, J. y Zador, D. (2000). A risk-benefit analysis of methadone maintenance treatment. Drug Safety, 22, 179-190. doi:10.2165/00002018-200022030-00002

Bileviciute-Ljungar, I., Häglund, V., Carlsson, J. y von Heijne, A. (2014). Clinical and radiological findings in methadone-induced delayed leukoencephalopathy. Journal of Rehabilitation Medicine, 46, 828-830. doi:10.2340/16501977-1820

Blaney, T. y Craig, R. J. (1999). Methadone maintenance: does dose determine differences in outcome? Journal of Substance Abuse Treatment, 16, 221-228. doi:10.1016/S0740-5472(98)00031-2

Bourgois, P. (2000). Disciplining addictions: The bio-politics of methadone and heroin in the United States. Culture, Medicine and Psychiatry, 24, 165-195. doi:10.1023/A:1005574918294

Bracken, B. K., Trksak, G. H., Penetar, D. M., Tartarini W. L., Maywalt, M. A., Dorsey, C. M. y Lukas, S. E. (2012). Response inhibition and psychomotor speed during methadone maintenance: impact of treatment duration, dose, and sleep deprivation. Drug and Alcohol Dependence, 125, 132-139. doi:10.1016/j.drugalcdep.2012.04.004

Brugal, M. T., Domingo-Salvany, A., Puig, R., Barrio, G., García de Olalla, P. y de la Fuente, L. (2005). Evaluating the impact of methadone maintenance programmes on mortality due to overdose and aids in a cohort of heroin users in Spain. Addiction, 100, 981-989. doi:10.1111/j.1360-0443.2005.01089.x

Bourgois, P. (2000). Disciplining addictions: The bio-politics of methadone and heroin in the United States. Culture, Medicine and Psychiatry, 24, 165-195.

Chen, I. C., Chie W. C., Hwu, H. G., Chou, S. Y., Yeh, Y. C., Yu, C. Y. y Tan, H. K. L. (2011). Alcohol use problem among patients in methadone maintenance treatment in Taiwan. Journal of Substance Abuse Treatment, 40, 142-149. doi:10.1016/j.jsat.2010.09.004

Chertkow, H., Nasreddine, Z., Johns, E., Phillips, N. y McHenry, C. (2011). The Montreal Cognitive Assessment (MoCA): Validation of alternate forms and new recommendations for education corrections. Alzheimer’s & Dementia, 7, S157. doi:10.1016/j.jalz.2011.05.423

Chugh, S. S., Socoteanu, C., Reinier, K., Waltz, J., Jui, J. y Gunson, K. (2008). A community-based evaluation of sudden death associated with therapeutic levels of methadone. American Journal of Medicine, 121, 66-71. doi:10.1016/j.amjmed.2007.10.009

Cohen, J. (1973). Eta-squared and partial eta-squared in fixed factor ANOVA designs. Educational and Psychological Measurement, 33, 107-112. doi:10.1177/001316447303300111

Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2ª ed.). Hillsdale, NJ: Erlbaum.

Copersino, M. L., Schretlen, D. J., Fitzmaurice, G., Lukas, S. E., Faberman, J., Sokoloff, J. y Weiss, R. D. (2012). Effects of cognitive impairment on substance abuse treatment attendance: predictive validation of a brief cognitive screening measure. American Journal of Drug and Alcohol Abuse, 38, 246-250. doi:10.3109/00952990.2012.670866

Curran, H. V., Bolton, J., Wanigaratne, S. y Smyth, C. (1999). Additional methadone increases craving for heroin: a double-blind, placebocontrolled study of chronic opiate users receiving methadone substitution treatment. Addiction, 94, 665-674. doi:10.1046/j.1360-0443.1999.9456654.x

Darke, S., McDonald, S., Kaye, S. y Torok, M. (2012). Comparative patterns of cognitive performance amongst opioid maintenance patients, abstinent opioid users and non-opioid users. Drug and Alcohol Dependence, 126, 309-315. doi:10.1016/j.drugalcdep.2012.05.032

D’Aunno, T., Folz-Murphy, N. y Lin, X. (1999). Changes in methadone treatment practices: results from a panel study, 1988-1995. American Journal of Drug and Alcohol Abuse, 25, 681-699. doi:10.1081/ADA-100101886

D’Aunno, T., Pollack, H. A., Frimpong, J. A. y Wuchiett, D. (2014). Evidence-based treatment for opioid disorders: A 23-year national study of methadone dose levels. Journal of Substance Abuse Treatment, 47, 245-250. doi:10.1016/j.jsat.2014.06.001

Deering, D., Sheridan, J., Sellman, J., Adamson, S., Pooley, S., Robertson, R.y Henderson, C. (2011). Consumer and treatment provider perspectives on reducing barriers to opioid substitution treatment and improving treatment attractiveness. Addictive Behaviors, 36, 636-642. doi:10.1016/j.addbeh.2011.01.004

De Las Cuevas, C., Gonzalez de Rivera, J. L., Henry Benitez, M., Monterrey, A. L., Rodriguez-Pulido, F. y Gracia Marco, R. (1991). Análisis factorial de la versión española del SCL-90-R en la población general. Anales de Psiquiatria, 7, 93-96.

De Maeyer, J., Vanderplasschen, W., Camfield, L., Vanheule, S., Sabbe, B. y Broekaert, E. (2011). A good quality of life under the influence of methadone: A qualitative study among opiate-dependent individuals. International Journal of Nursing Studies, 48, 1244-1257. doi:10.1016/j.ijnurstu.2011.03.009

De Maeyer, J., Vanderplasschen, W., Lammertyn, J., van Nieuwenhuizen, C., Sabbe, B. y Broekaert, E. (2011). Current quality of life and its determinants among opiate-dependent individuals five years after starting methadone treatment. Quality of Life Research, 20, 139-150. doi:10.1007/s11136-010-9732-3

Derogatis, L. R. (1992). SCL-90-R: Administration, scoring and procedures manual for the R (evised) version and other instruments of the psychopathology rating scale series. Towson: Clinical Psychometric Research.

Dobler-Mikola, A., Hattenschwiler, J., Meili, D., Beck, T., Boni, E., Modestin, J. (2005). Patterns of heroin, cocaine, and alcohol abuse during long-term methadone maintenance treatment. Journal of Substance Abuse Treatment, 29, 259-265. doi :10.1016/j.jsat.2005.08.002

Eiden, C., Leglis, Y., Clarivet, B., Blayac, J. P. y Peyrière, H. (2012). Co-morbidités psychiatriques associées à des fortes posologies de méthadone (>100 mg/j): analyse rétrospective d’une cohorte de patients traités. Thérapie, 67, 223-230. doi :10.2515/therapie/2012025

Faggiano, F., Vigna-Taglianti, F., Versino, E. y Lemma, P. (2003). Methadone maintenance at different dosages for opioid dependence. Cochrane Database of Systematic Reviews, 3, CD002208. doi:10.1002/14651858.CD002208

Fareed, A., Vayalapalli, S., Stout, S., Casarella, J., Drexler, K. y Bailey, S. P. (2010). Effect of methadone maintenance treatment on heroin craving, a literature review. Journal of Addictive Diseases, 30, 27-38. doi:10.1080/10550887.2010.531672

Farré, M., Mas, A., Torrens, M., Moreno, V. y Camí, J. (2002). Retention rate and illicit opioid use during methadone maintenance interventions: a meta-analysis. Drug and Alcohol Dependence, 65, 283-290. doi:10.1016/S0376-8716(01)00171-5

Fernández Miranda, J. J. (2001). Efectividad de los programas de mantenimiento con metadona. Una revisión de los resultados de los estudios de evaluación. Medicina Clínica (Barcelona), 116, 150-154.

Fernández Miranda, J. J. (2004). Calidad asistencial y cronicidad en los programas de mantenimiento con agonistas opiáceos. Adicciones, 16, 109-116.

Fernández Miranda, J. J., González García-Portilla, M. P., Sáiz Martínez, P.A., Gutiérrez Cienfuegos, E, Bobes García, J. (1999). Calidad de vida y severidad de la adicción en heroinómanos en mantenimiento prolongado con metadona. Adicciones, 11, 43-52.

González de Rivera, J. L., Derogatis, L. R., de las Cuevas, C., Gracia Marco, R., Rodríguez-Pulido, F., Henry-Benítez, M. y Monterrey, A. L. (1989). The Spanish version of the SCL-90-R. Normative data in the general population. Towson: Clinical Psychometric Research.

Grönbladh, L. y Öhlund, L. S. (2011). Self-reported differences in side-effects for 110 heroin addicts during opioid addiction and during methadone treatment. Heroin Addiction and Related Clinical Problems, 13, 5-12.

Gruber, S. A., Tzilos, G. K., Silveri, M. M., Pollack, M., Renshaw, P. F., Kaufman, M. J. y Yurgelun-Todd, D. A. (2006). Methadone maintenance improves cognitive performance after two months of treatment. Experimental and Clinical Psychopharmacology, 14, 157-164. doi:10.1037/1064-1297.14.2.157

Hall, W., Carter, A. y Forlini, C. (2015). The brain disease model of addiction: is it supported by the evidence and has it delivered on its promises? Lancet Psychiatry, 2, 105-110. doi:10.1016/S2215-0366(14)00126-6

Hammer, R., Dingel, M., Ostergren, J., Partridge, B., McCormick, J. y Koenig, B. A. (2013). Addiction: Current criticism of the brain disease paradigm. American Journal of Bioethics Neuroscience, 4, 27-32. doi:10.1080/21507740.2013.796328

Habrat, B., Chmielewska, K., Baran-Furga, H., Keszycka, B. y Taracha, E. (2002). Subjective Quality of Life in opiate-dependent patients before admission after six months and one-year participation in methadone program. Przegl Lek, 59, 351-354.

Harris, J. y McElrath, K. (2012). Methadone as social control: Institutionalized stigma and the prospect of recovery. Qualitative Health Research, 22, 810–824. doi:10.1177/1049732311432718

Harris, M. y Rhodes, T. (2013). Methadone diversion as a protective strategy: the harm reduction potential of ‘generous constraints’. International Journal of Drug Policy, 24, e43-e50. doi:10.1016/j.drugpo.2012.10.003

Hartgers, C., van den Hoek, A., Krijnen, P. y Coutinho, R. A. (1992). HIV prevalence and risk behavior among injecting drug users who participate in ‘Low-Threshold’ methadone programs in Amsterdam. American Journal of Public Health, 82, 547-551. doi:10.2105/AJPH.82.4.547

He, Q., Wang, X., Xia, Y., Mandel, J. S., Chen, A., Zhao, L., … Ling, L. (2011). New community-based methadone maintenance treatment programs in Guangdong, China, and their impact on patient quality of life. Substance Use & Misuse, 46, 749-757. doi:10.3109/10826084.2010.534124

Hooper, D., Coughlan, J. y Mullen, M. R. (2008). Structural equation modelling: Guidelines for determining model fit. Electronic Journal of Business Research Methods, 6, 53- 60.

Karow, A., Verthein, U., Pukrop, R., Reimer, J., Haasen, C., Krausz, M. y Schäfer, I. (2011). Quality of life profiles and changes in the course of maintenance treatment among 1,015 patients with severe opioid dependence. Substance Use & Misuse, 46, 705-715. doi:10.3109/10826084.2010.509854

Katz, N. (2005). The impact of opioids on the endocrine system. Pain Management Rounds, 1, 1-6. doi:10.1097/AJP.0b013e3181850df6

Keen, J., Oliver, P., Rowse, G. y Mathers, N. (2003). Does methadone maintenance treatment based on the new national guidelines work in a primary care setting? British Journal of General Practice, 53, 461-467.

Kelly, S. M., O’Grady, K. E., Brown, B. S., Mitchell, S. G. y Schwartz, R. P. (2010). The role of patient satisfaction in methadone treatment. American Journal of Drug and Alcohol Abuse, 36, 150–154. doi:10.3109/00952991003736371

Kelly, S. M., O’Grady, K. E., Brown, B. S., Mitchell, S. G. y Schwartz, R. P. (2011). Predictors of methadone treatment retention from a multi-site study: A survival analysis. Drug & Alcohol Dependence, 117, 170-175. doi:10.1016/j.drugalcdep.2011.01.008

Krantz, M. J., Kutinsky, I. B., Robertson, A. D. y Mehler, P. S. (2003). Dose-related effects of methadone on QT prolongation in a series of patients with torsade de pointes. Pharmacotherapy, 23, 802-805. doi:10.1592/phco.23.6.802.32186

Krantz, M. J., Martin, J., Stimmel, B., Mehta, D. y Haigney, M. C. P. (2009). QTc interval screening in methadone treatment. Annals of Internal Medicine, 150, 387-395. doi:10.7326/0003-4819-150-1-200903170-00104

Langendam, M. W., Van Brussel, G. H., Coutinho, R. A. y Van Ameijden, E. J. (2001). The impact of harm-reduction-based methadone treatment on mortality among heroin users. American Journal of Public Health, 91, 774-780. doi:10.2105/AJPH.91.5.774

Leavitt, S. B. (2003). Methadone dosing & safety in the treatment of opioid addiction. Addiction Treatment Forum, 12, 1-8.

Leshner, A. I. (1997). Addiction is a brain disease, and it matters. Science, 278, 45-47. doi:10.1126/science.278.5335.45

Liao, D. L., Chen, P. C., Chen, C. H., Hsieh, C. J., Huang, Y. F., Shih, W. Y. y Cheng, J. J. (2013). Higher methadone doses are associated with lower mortality in patients of opioid dependence in Taiwan. Journal of Psychiatric Research, 47, 1530-1534. doi:10.1016/j.jpsychires.2013.07.001

Lina, C., Wu, Z. y Detels, R. (2011). Family support, quality of life and concurrent substance use among methadone maintenance therapy clients in China. Public Health, 125, 269-274. doi:10.1016/j.puhe.2011.01.009

Lingford-Hughes, A. R., Welch, S. y Nutt, D. J. (2004). Evidence-based guidelines for the pharmacological management of substance misuse, addiction and comorbidity: recommendations from the British Association for Psychopharmacology. Journal of Psychopharmacology, 18, 293-336. doi:10.1177/0269881104048516

Liu, E., Rou, K., McGoogan, J. M., Pang, L., Cao, X., Wang, C., ... y Wu, Z. (2013). Factors associated with mortality of HIV-positive clients receiving methadone maintenance treatment in China. Journal of Infectious Diseases, 208, 442-453. doi:10.1093/infdis/jit163

Loeber, S., Kniest, A., Diehl, A., Mann, K. y Croissant, B. (2008). Neuropsychological functioning of opiate-dependent patients: A nonrandomized comparison of patients preferring either buprenorphine or methadone maintenance treatment. American Journal of Drug and Alcohol Abuse, 34, 584–593. doi:10.1080/00952990802308239

Lucas-Carrasco, R. (2012). The WHO quality of life (WHOQOL) questionnaire: Spanish development and validation studies. Quality of Life Research, 21, 161-165. doi:10.1007/s11136-011-9926-3

Maddux, J. F., Desmond, D. P. y Vogtsberger, K. N. (1995). Patient-regulated methadone dose and optional counseling in methadone maintenance. American Journal on Addictions, 4, 18-32. doi:10.1111/j.1521-0391.1995.tb00255.x

Maddux, J. F., Prihoda, T. J. y Vogtsberger, K. N. (1997). The relationship of methadone dose and other variables to outcomes of methadone maintenance. American Journal on Addictions, 6, 246–255. doi:10.1111/j.1521-0391.1997.tb00404.x

Maremmani, I., Pacini, M., Lubrano, S. y Lovrecic, M. (2003). When “enough” is still not “enough”: effectiveness of high-dose methadone in the treatment of heroin addiction. Heroin Addiction & Related Clinical Problems, 5, 17-32.

Mattick, R. P., Breen, C., Kimber, J. y Davoli, M. (2009). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database of Systematic Reviews, 3, CD002209. doi:10.1002/14651858.CD002209.pub2

Maxwell, S. y Shinderman, M. (1999). Optimizing response to methadone maintenance treatment: use of higher-dose methadone. Journal of Psychoactive Drugs, 31, 95-102. doi:10.1080/02791072.1999.10471730

Millson, P., Challacombe, L., Villeneuve, P. J., Strike, C. J., Fischer, B., Myers, T., ... Hopkins, S. (2006). Determinants of health-related quality of life of opiate users at entry to low-threshold methadone programs. European Addiction Research, 12, 74-82. doi:10.1159/000090426

Millson, P. E., Challacombe, L., Villeneuve, P. J., Fischer, B., Strike, C. J., Myers, T., … Pearson, M. (2004). Self-perceived health among Canadian opiate users: a comparison to Canadian the general population and to other chronic disease populations. Canadian Journal of Public Health, 95, 99-103.

Millson, P., Challacombe, L., Villeneuve, P. J., Strike, C. J., Fischer, B., Myers, T., … Hopkins, S. (2007). Reduction in injection–related hiv risk after 6 months in a low-threshold methadone treatment program. AIDS Education and Prevention, 19, 124–136. doi:10.1521/aeap.2007.19.2.124

Mino, A., Page, D., Dumont, P. y Broers, B. (1998). Treatment failure and methadone dose in a public methadone maintenance treatment programme in Geneva. Drug and Alcohol Dependence, 50, 233-239. doi:10.1016/S0376-8716(98)00035-0

Mintzer, M. Z., Copersino, M. L. y Stitzer, M. L. (2005). Opioid abuse and cognitive performance. Drug and Alcohol Dependence, 78, 225–230. doi:10.1016/j.drugalcdep.2004.10.008

Mintzer, M. Z. y Stitzer, M. L. (2002). Cognitive impairment in methadone maintenance patients. Drug and Alcohol Dependence, 67, 41-51. doi:10.1016/S0376-8716(02)00013-3

Montgomery, L. T., Sanning, B., Litvak, N. y Peters, E. N. (2014). Preliminary findings on the association between clients’ perceived helpfulness of substance abuse treatment and outcomes: Does race matter? Drug and Alcohol Dependence, 139, 152-158. doi:10.1016/j.drugalcdep.2014.03.026

Musshoff, F., Trafkowski, J., Lichtermann, D. y Madea, B. (2010). Comparison of urine results concerning co-consumption of illicit heroin and other drugs in heroin and methadone maintenance programs. International Journal of Legal Medicine, 124, 499-503. doi:10.1007/s00414-009-0361-8

Nasreddine, Z. S., Phillips, N. A., Bédirian, V., Charbonneau, S., Whitehead, V., Collin, I…. Chertkow, H. (2005). The Montreal Cognitive Assessment, MoCA: a brief screening tool for mild cognitive impairment. Journal of the American Geriatrics Society, 53, 695-699. doi:10.1111/j.1532-5415.2005.53221.x

Nosyk, B., Guh, D. P., Sun, H., Oviedo-Joekes, E., Brissette, S., Marshd, D. C., … Anis, A. H. (2011). Health related quality of life trajectories of patients in opioid substitution treatment. Drug and Alcohol Dependence, 118, 259-264. doi:10.1016/j.drugalcdep.2011.04.003

Nosyk, B., Marsh, D. C., Sun, H., Schechter, M. T. y Anis, A. H. (2010). Trends in methadone maintenance treatment participation, retention, and compliance to dosing guidelines in British Columbia, Canada: 1996–2006. Journal of Substance Abuse Treatment, 39, 22-31. doi:10.1016/j.jsat.2010.03.008

Notley, C., Blyth, A., Maskrey, V., Pinto, H. y Holland, R. (2015). Exploring the concepts of abstinence and recovery through the experiences of long-term opiate substitution clients. Substance Abuse, 36, 232-239. doi:10.1080/08897077.2014.941085

Pacini, M., Maremmani, A. G. I., Rovai, L., Rugani, F. y Maremmani, I. (2010). Treating heroin addicts. Blocking dosages and stimulation-stabilization of opioidergic system. Heroin Addiction & Related Clinical Problems, 12, 41-48.

Padaiga, Z., Subata, E. y Vanagas. G. (2007). Outpatient methadone maintenance treatment program. Quality of life and health of opioid-dependent persons in Lithuania. Medicina (Kaunas), 4, 235-241.

Pedrero Pérez, E. J. y López-Durán, A. (2005). Autoinformes de sintomatología depresiva en drogodependientes: nivel de coincidencia del BDI, SCL-90-R y MCMI-II. ¿Depresión o malestar inespecífico? Adicciones, 17, 215-230.

Pérez de los Cobos, J., Fidel, G., Escuder, G., Haro, G., Sánchez, N., Pascual, C.,… , Trujols, J. (2004). A satisfaction survey of opioid-dependent clients at methadone treatment centres in Spain. Drug and Alcohol Dependence, 73, 307-313. doi:10.1016/j.drugalcdep.2003.11.001

Perreault, M., Héroux, M. C., White, N. D., Lauzon, P., Mercier, C. y Rousseau, M. (2007). Treatment retention and evolution of clientele in a low threshold methadone substitution treatment program in Montreal. Canadian Journal of Public Health, 98, 33-36.

Peterson, J. A., Schwartz, R. P., Mitchell, S. G., Reisinger, H. S., Kelly, S. M., O’Grady, K. E…. Agar, M. H.. (2010). Why don’t out-of-treatment individuals enter methadone treatment programmes? International Journal of Drug Policy, 21, 36-42. doi:10.1016/j.drugpo.2008.07.004

Preston, K. L., Umbricht, A. y Epstein, D. H. (2000). Methadone dose increase and abstinence reinforcement for treatment of continued heroin use during methadone maintenance. Archives of General Psychiatry, 57, 395-404. doi:10.1001/archpsyc.57.4.395.

Rass, O., Kleykamp, B. A., Vandrey, R. G., Bigelow, G. E., Leoutsakos, J. M., Stitzer, M. L., … Mintzer, M. Z. (2014). Cognitive performance in methadone maintenance patients: effects of time relative to dosing and maintenance dose level. Experimental and Clinical Psychopharmacology, 22, 248-256. doi:10.1037/a0035712

Rodríguez, M., Jiménez-Lerma, J. M., Iraurgi, I., Murua, F., Bacigalupe, L., Chavarri, M. R., & Balsategi, B. (2002). Evaluación de la satisfacción con el tratamiento en un centro ambulatorio de drogodependencias a través del Treatment Perceptions Questionnaire (TPQ). Adicciones, 14, 1-8.

Rojo-Mota, G., Pedrero-Pérez, E. J., Ruiz-Sánchez de León, J. M., Llanero-Luque, M. y Puerta-García, C. (2013). Cribado neurocognitivo en adictos a sustancias: la evaluación cognitiva de Montreal. Revista de Neurología, 56, 129-136.

Roncero, C., Fuste, G., Barral, C., Rodríguez-Cintas, L, Martínez-Luna, N., Eiroa-Orosa, F. J., Casas, M, on behalf of the PROTEUS study investigators. (2011). Therapeutic management and comorbidities in opiate-dependent patients undergoing a replacement therapy programme in Spain: the PROTEUS study. Heroin Addiction and Related Clinical Problems, 13, 5-16.

Roy, A. K., McCarthy, C., Kiernan, G., McGorrian, C., Keenan, E., Mahon, N. G. y Sweeney, B. (2012). Increased incidence of QT interval prolongation in a population receiving lower doses of methadone maintenance therapy. Addiction, 107, 1132-1139. doi:10.1111/j.1360-0443.2011.03767.x

Ruggeri, M., Lasalvia, A., Dall’Agnola, R., Van Wijngaarden, B., Knudsen, H.C., Leese, M., .... y The Epsilon Study Group (2000). Development, internal consistency and reliability of the Verona Service Satisfaction Scale - European Version. British Journal of Psychiatry, 177, s41-s48. doi:10.1192/bjp.177.39.s41

Schwartz, R. P., Highfield, D. A., Jaffe, J. H., Brady, J. V., Butler, C. B., Rouse, C. O., … Breteler, M. M. B. (2006). A randomized controlled trial of interim methadone maintenance. Archives of General Psychiatry, 63, 102-109. doi:10.1001/archpsyc.63.1.102.

Senbanjo, R., Wolff, K. I. M., Marshall, E y Strang, J. (2009). Persistence of heroin use despite methadone treatment: Poor coping self-efficacy predicts continued heroin use. Drug and Alcohol Review, 28, 608-615. doi:10.1111/j.1465-3362.2009.00064.x

Servicio Andaluz de Salud (2010). Desarrollo de Programas de Tratamiento Asertivo Comunitario en Andalucía. Documento marco. Anexo 3.1. Granada: Área de Dirección de Organizaciones Sanitarias de la Escuela Andaluza de Salud Pública.

Skevington, S. M., Lotfy, M. y O’Connell, K. A. (2004). The World Health Organization’s WHOQOL-BREF quality of life assessment: psychometric properties and results of the international field trial. A report from the WHOQOL group. Quality of life Research, 13, 299-310. doi:10.1023/B:QURE.0000018486.91360.00

Skevington, S. M., Sartorius, N., Amir, M., and THE WHOQOL Group. (2004). Developing methods for assessing quality of life in different cultural settings. Social Psychiatry and Psychiatric Epidemiology, 39, 1-8. doi:10.1007/s00127-004-0700-5

Torrens, M., Castillo, C. y Perez-Sola, V. (1996). Retention in a low threshold methadone maintenance program. Drug and Alcohol Dependence, 41, 55-59. doi:10.1016/0376-8716(96)01230-6

Torrens, M., Domingo-Salvany, A., Alonso, J., Castillo, C. y San, L. (1999). Methadone and quality of life. Lancet, 353, 1101. doi:10.1016/S0140-6736(05)76462-X

Trujols, J., Portella, M. J., Iraurgi, I., Campins, M. J., Siñol, N. y Pérez de los Cobos, J. (2013). Patient-reported outcome measures: Are they patient-generated, patient-centred or patient-valued? Journal of Mental Health, 22, 555-562. doi:10.3109/09638237.2012.734653

Trujols, J. y Pérez de los Cobos, J. (2005). La perspectiva de los usuarios sobre los tratamientos de mantenimiento con metadona: una revisión centrada en la satisfacción con el tratamiento. Adicciones, 17, s181-s204.

Van Ameijden, E. J., Langendam, M. W. y Coutinho, R. A. (1999). Dose-effect relationship between overdose mortality and prescribed methadone dosage in low threshold maintenance programs. Addictive Behaviours, 24, 559-563. doi:10.1016/S0306-4603(98)00083-5

Vanderplasschen, W., Naert, J., Vander Laenen, F. y De Maeyer, J. (2015). Treatment satisfaction and quality of support in outpatient substitution treatment: opiate users’ experiences and perspectives. Drugs: education, prevention, and policy, 22, 272-280. doi:10.3109/09687637.2014.981508

Verdejo, A., Toribio, I., Orozco, C., Puente, K. L. y Pérez-García, M. (2005). Neuropsychological functioning in methadone maintenance patients versus abstinent heroin abusers. Drug and Alcohol Dependence, 78, 283-288. doi:10.1016/j.drugalcdep.2004.11.006

Villeneuve, P. J., Challacombe, L., Strike, C. J., Myers, T., Fischer, B., Shore, R., Hopkins, S. y Millson, P. E. (2006). Change in health-related quality of life of opiate users in low-threshold methadone programs. Journal of Substance Use, 11, 137-149. doi:10.1080/14659890500256945

Walker, P. W., Klein, D. y Kasza, L. (2003). High dose methadone and ventricular arrhythmias: a report of three cases. Pain, 103, 321-324. doi:10.1016/S0304-3959(02)00461-X

Wang, P. W., Wu, H. C., Yen, C. N., Yeh, Y. C., Chung, K. S., Chang, H. C. y Yen C, F. (2012). Change in quality of life and its predictors in heroin users receiving methadone maintenance treatment in Taiwan: An 18-month follow-up study. American Journal of Drug and Alcohol Abuse, 38, 213-219. doi:10.3109/00952990.2011.649222

Webster, L. R. (2013). Methadone side effects: Constipation, respiratory depression, sedation, sleep-disordered breathing, and the endocrine system. En Cruciani, R. A. y Knotkova H., Handbook of Methadone Prescribing and Buprenorphine Therapy (pp. 39-49). New York: Springer.

White, W. y Mojer-Torres, L. (2010). Recovery-oriented methadone maintenance. Chicago (IL): Great Lakes Addiction Technology Transfer Center, Philadelphia Department of Behavioral Health and Mental Retardation Services and Northeast Addiction Technology Transfer Center.

WHO (2004). The World Health Organization Quality of Life (WHOQOL)-BREF World Health Organization. Recuperado de http://www.who.int/substance_abuse/research_tools/whoqolbref/en/

Zeldman, A., Ryan, R. M. y Fiscella, K. (2004). Motivation, autonomy support, and entity beliefs: Their role in methadone maintenance treatment. Journal of Social and Clinical Psychology, 23, 675-696. doi:10.1521/jscp.23.5.675.50744




DOI: http://dx.doi.org/10.20882/adicciones.831