Aging in a methadone maintenance program. A perspective from the framework of social determinants of health
e201908048
Keywords:
Chronicity, Social determinants of health, Aging, Methadone, Vulnerability, Stigma, HIVAbstract
Background: People on methadone treatment have increased their life expectancy, aging prematurely with comorbidities. The objective of this study was to know the sociodemographic and clinical profile of these people in the Center for Addiction Care in the district of Latina (belonging to Madrid Salud), as well as the perception of the influence of the treatment on their aging. The Social Determinants of Health Model was used as a framework.
Methods: A mixed methodology was used in two phases: a quantitative one, to describe the sociodemographic and clinical characteristics of the study population; and another qualitative one, through semi-structured interviews to an intentional sample, to explore the history of life and the perception of future needs regarding the health of the participants.
Results: The results highlighted that the average age of the sample was 48.28 years, that they were mostly men (81.25%), of Spanish origin, with a low level of education and economics and with a medium stay in treatment with methadone of ± 13 years. An increase in mental pathologies was found the more years they had been in the program, as well as, at a lower age of onset in consumption, the presence of HIV and Hepatitis C virus increased. In their speeches it was found that the social determinants of Health have conditioned its vital history.
Conclusions: Both consumption and methadone contribute to its stigmatization, not favoring its normalized inclusion in society and determining a high state of vulnerability. This increases as age does, not receive adequate resources to meet their future needs.
Downloads
References
Observatorio Europeo de las Drogas. Informe europeo sobre drogas. Tendencias y novedades, 2015. 2016; Available at: http://www.emcdda.europa.eu/system/files/publications/4541/TDAT17001ESN.pdf.
Instituto de Adicciones, Madrid Salud. Memoria anual 2010. 2011; Available at: http://madridsalud.es/prevencion-y-atencion-integral-a-las-adicciones/.
Instituto de Adicciones, Madrid Salud. Memoria Anual 2015. 2016; Available at: http://madridsalud.es/prevencion-y-atencion-integral-a-las-adicciones/.
Rosen D, Smith ML, Reynolds III CF. The prevalence of mental and physical health disorders among older methadone patients. The American Journal of Geriatric Psychiatry 2008;16(6):488-497.
Observatorio español de las drogas y las toxicomanías. Informe 2016 Alcohol, tabaco y drogas ilegales en España. 2016; Available at: http://www.pnsd.msssi.gob.es/profesionales/sistemasInformacion/informesEstadisticas/pdf/2016_INFORME_OEDT.pdf.
Kao DP, Haigney MCP, Mehler PS, Krantz MJ. Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration. Addiction 2015 Sep;110(9):1468-1475.
Van den Beuken-Van Everdingen HJ, Geurts JW, Patijn J. Prolonged QT interval by methadone: Relevance for daily practice? A prospective study in patients with cancer and noncancer pain. Journal of Opioid Management 2017 /03/31;9(4):263-267.
Li W, Li Q, Wang Y, Zhu J, Ye J, Yan X, et al. Methadone induced damage to white matter integrity in methadone maintenance patients: a longitudinal self-control DTI study. Scientific reports 2016;6(1):1-8.
García Gonzalo MA, Santamaría Mas MI, Pascual Tomé L, Ibagurren Pinilla M, Rodríguez-Arrondo F. Estudio transversal de comorbilidades y medicaciones concomitantes en una cohorte de pacientes infectados por el virus de la inmunodeficiencia humana. Atención Primaria 2016 Oct;49(5):286-293.
Mateu G, Astals M, Torrens M. Comorbilidad psiquiátrica y trastorno por dependencia de opiáceos: del diagnóstico al tratamiento. Adicciones: Revista de socidrogalcohol 2005;17(2):111-122.
Goffman E. Estigma. La identidad deteriorada. 1st ed. Buenos Aires: Amorrortu; 1970.
García del Castillo, J A. Concepto de vulnerabilidad psicosocial en el ámbito de la salud y las adicciones. Health and Additions 2015;15(1):5-13.
Serrano P. La vulnerabilidad, antesala de las desigualdades en salud. Metas de enfermería 2015;18(4):3.
World Health Organitation. Determinantes Sociales de la Salud. 2008; Available at: http://www.who.int/social_determinants/es/. Accessed Nov 19, 2016.
Departament of Defense, Office of Secretary. TRICARE. Mental Health and Substance Use Disorder Treatment. Final rule. Fed Regist 2016 Sep 2;81(171):61067-61098.
Han B, Polydorou S, Ferris R, Blaum CS, Ross S, McNeely J. Demographic trends of adults in New York City opioid treatment programs: an aging population. Substance Use & Misuse 2015 November 10;50(13):1660-1667.
Creswell JW. A concise introduction to mixed methods research. 1st ed. University of Nebraska. Lincoln: Sage Publications; 2015.
Madrid Salud. Centros de Atención a las Drogodependencias (CAD). 2016; Available at: http://madridsalud.es/centros-de-atencion-a-drogodependencias-cad/. Accessed abril, 2017.
Taylor SJ, Bogdan R, DeVault M. Introduction to qualitative research methods: A guidebook and resource. : John Wiley & Sons; 2015.
Pedraz A, Zarco J, Ramasco M, Palmar A. Investigación cualitativa. 1st ed. Barcelona: Elsevier; 2014.
Díaz-Olalla JM, Benítez-Robredo T. Estudio de salud de la ciudad de Madrid 2014. 2015.
Leone B, Di Nicola M, Moccia L, Pettorruso M, De Risio L, Nucara G, et al. Gender-related psychopathology in opioid use disorder: results from a representative sample of Italian addiction services. Addictive Behaviors 2017 august;71(1):107-110.
Tran BX, Vu PB, Nguyen LH, Latkin SK, Nguyen CT, Phan HTT, et al. Drug addiction stigma in relation to methadone maintenance treatment by different service delivery models in Vietnam. BMC public health 2016;16(1):238.
Carrera I, Sánchez L, Sabater E, Pereiro C, Flórez G, Conde M, et al. Study on users’ perception of agonist opioid treatment in the Galician network of drug addiction. Heroin Addiction and Related Clinical Problems 2016;18(3):29-42.
Lin C, Chang K, Wang J, Lee LJ. Quality of life and its determinants for heroin addicts receiving a methadone maintenance program: Comparison with matched referents from the general population. Journal of the Formosan Medical Association = Taiwan yi zhi 2016 Sep;115(9):714-727.
World Health Organization. Estrategia Mundial del sector de la salud contra las Hepatitis Víricas 2016-2021. World Health Organization 2016 Jun.
Hser Y, Liang D, Lan Y, Vicknasingam B, Chakrabarti A. Drug Abuse, HIV, and HCV in Asian Countries. J Neuroimmune Pharmacol 2016 Sep;11(3):383-393.
Naji L, Burns Dennis B, Bawor M, Varenbut M, Daiter J, Plater C, et al. The association between age of onset of opioid use and comorbidity among opioid dependent patients receiving methadone maintenance therapy. Addiction Science & Clinical Practice 2017 Jan 1;12(9):1-7.
Martínez-Luna NG, Rodríguez-Cintas L, Esojo A, Palma-Álvarez RF, Robles-Martínez M, Grau-López L, et al. Harm reduction program use, psychopathology and medical severity in patients with methadone maintenance treatment. Adicciones 2018 Jan 15;30(3):197.
Melin Y, Eklund M, Lindgren B. Experiences of living with opioid dependence: an interview study among individuals participating in medication-assisted treatment. Issues in Mental Health Nursing 2017 January 2;38(1):9-17.
LaMart Hightower. A Phenomenological Study of Methadone Treatment by Opiate-Dependent Individuals Ages 50–55 YearsProQuest Dissertations Publishing; 2016.
Pascual Mollá M, Pascual Pastor F. Stigma in the addicted person. Adicciones 2017 Sep 29;29(4):223.
Cousins G, Boland F, Barry J, Lyons S, Keenan E, O´Driscoll D, et al. J-shaped relationship between supervised methadone consumption and retention in methadone maintenance treatment (MMT) in primary care: National cohort study. Drug and Alcohol Dependence 2017 Apr;173(1):126-131.
Srivastava A, Kahan M, Nader M. Primary care management of opioid use disorders: Abstinence, methadone, or buprenorphine-naloxone? Canadian Family Physician 2017 Mar 1,;63(3):200.
Abousaidi H, Hosseini OR, Bidaki R, Fathollahi MS, Reza H, Nejad G, et al. Viral and Psychiatric Disorders in Methadone Maintenance Therapy (MMT) Clients. Thrita 2016 Mar 27;5(4):5.
Pedrero-Pérez EJ, MethaQoL G. Methadone dosage and its relationship to quality of life, satisfaction, psychopathology, cognitive performance and additional consumption of non-prescribed drugs. Adicciones 2017;29(1):18.
Kolind T, Hesse M. Patient-centred care, perhaps the future of substance abuse treatment. Addiction 2017 Mar;112(3):465-466.
Downloads
Published
Versions
- 2019-08-26 (2)
- 2019-08-26 (1)
How to Cite
Issue
Section
Categories
License
Copyright (c) 2019 Rubén Martín Bravo

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Usted es libre de:
Compartir — copiar y redistribuir el material en cualquier medio o formato.
La licenciante no puede revocar estas libertades en tanto usted siga los términos de la licencia.
Bajo los siguientes términos:
Atribución — Usted debe dar crédito de manera adecuada , brindar un enlace a la licencia, e indicar si se han realizado cambios. Puede hacerlo en cualquier forma razonable, pero no de forma tal que sugiera que usted o su uso tienen el apoyo de la licenciante.
NoComercial — Usted no puede hacer uso del material con propósitos comerciales.
SinDerivadas — Si remezcla, transforma o crea a partir del material, no podrá distribuir el material modificado.
No hay restricciones adicionales — No puede aplicar términos legales ni medidas tecnológicas que restrinjan legalmente a otras a hacer cualquier uso permitido por la licencia.
Avisos:
No tiene que cumplir con la licencia para elementos del material en el dominio público o cuando su uso esté permitido por una excepción o limitación aplicable.
No se dan garantías. La licencia podría no darle todos los permisos que necesita para el uso que tenga previsto. Por ejemplo, otros derechos como publicidad, privacidad, o derechos morales pueden limitar la forma en que utilice el material.