Effectiveness of Therapies for Heroin Addiction in Retaining Patients in Treatment: Results From the VEdeTTE Study

• Published in: Substance use & misuse Vol. 45; no. 12; pp. 2076 - 2092
• Main Authors: Salamina, Giuseppe, Diecidue, Roberto, Vigna-Taglianti, Federica, Jarre, Paolo, Schifano, Patrizia, Bargagli, Anna Maria, Davoli, Marina, Amato, Laura, Perucci, Carlo Alberto, Faggiano, Fabrizio, The VEde TTE Study Group
• Format: Journal Article
• Language: English
• Published: England Informa UK Ltd 01.10.2010; Taylor & Francis; Taylor & Francis Ltd
• Subjects: Addictions; Adolescent; Adult; Aged; Attrition; Cocaine; Comorbidity; Dropping out; Drug Abuse; Drug use; Effectiveness; Female; Health services; Heroin; heroin addiction; Heroin Dependence - therapy; Humans; Living alone; Male; Methadone; Methadone - therapeutic use; methadone dose; methadone maintenance; Middle Aged; Morbidity; Multivariate Analysis; Naltrexone - therapeutic use; Narcotic Antagonists - therapeutic use; Patient Acceptance of Health Care; Patients; Personal information; Privacy; Psychotherapy; Retention; Risk; Risk factors; Social Problems; Social Support; Substance abuse treatment; Substance Abuse Treatment Centers; Therapeutic communities; therapeutic community; Treatment methods; Treatment Outcome; Treatment Outcomes; treatment retention
• ISSN: 1082-6084; 1532-2491; 1532-2491
• DOI: 10.3109/10826081003791932

Treatment is effective in reducing heroin use and clinical and social problems among heroin addicts. The effectiveness is related to the duration of treatment. "VEdeTTE" is an Italian longitudinal study funded by the Ministry of Health to evaluate the effectiveness of treatments provided by the National Health Services. The study involved 115 drug treatment centers and 10,454 heroin users. Clinical and personal information were collected at intake through a structured interview. Treatments were recorded using a standardized form. Survival analysis and Cox Proportional Hazard model were used to evaluate treatment retention. Five thousand four hundred and fifty-seven patients who started a treatment in the 18 months of the study were included in the analysis: 43.2% received methadone maintenance therapy (MMT), 10.5% therapeutic community, and 46.3% abstinence-oriented therapy (AOT). The likelihood of remaining in treatment was 0.5 at 179 days. The median daily dose of methadone was 37 mg. Psychotherapy was provided in 7.6% of patients receiving methadone and 4.9% of those in therapeutic community. Type of therapy was the strongest predictor of retention, with AOT showing the lowest retention. In MMT patients, retention improved according to dose. Living alone, psychiatric comorbidity and cocaine use increased the risk of dropout. Psychotherapy associated halved the risk of dropout.