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.

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Referencias


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DOI: https://doi.org/10.20882/adicciones.831

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