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• W3179357106 abstract "Colombia is facing a rising epidemic of intravenous heroin use. Knowledge of the methadone-assisted treatment programmes in the country is crucial in order to propose improvement strategies. 13 programmes from priority regions were surveyed. The demographic and clinical characteristics of the patients attending the programmes, a description of the services offered, their methadone treatment protocols, the various barriers to treatment and the causes of treatment abandonment were reviewed. 12/13 questionnaires were analysed with a total of 538 active patients. Most of the patients attending these programmes were men (85.5%) between 18 and 34 years-old (70%). Forty percent (40%) were intravenous drug users and 25% admitted sharing needles. The comorbidities associated with heroin use were mental illness (48%), hepatitis C (8.7%) and HIV (2%). Psychiatric comorbidity was more likely in patients attending the private sector (69.8% vs. 29.7%; p < 0.03). The initial average dose of methadone administered was 25.3 ± 8.9 mg/day, with a maintenance dose ranging from 41 to 80 mg/day. Lack of alignment with primary care was perceived to be the most serious barrier to access, ahead of problems with insurance and prejudice towards treatment with methadone (p < 0.05). Health Administration and insurance problems (p < 0.003), together with the lack of availability of methadone (p < 0.018) and relapse (p < 0.014) were the most important reasons for abandonment of treatment. The treatment protocols of these programmes offer different levels of development and implementation. Some of the barriers to access and reasons for abandonment of treatment with methadone can be mitigated with better health administration. Colombia está enfrentado una epidemia emergente del consumo endovenoso de heroína. Un conocimiento de los programas existentes que ofrecen tratamiento asistido con metadona en el país es necesario para que se puedan proponer estrategias de mejoría. Se encuestaron 13 programas de regiones prioritarias. Se evaluaron las características demográficas y clínicas de los usuarios, así como los servicios ofrecidos por estos programas, sus protocolos de tratamiento con metadona y las diferencias en las barreras al tratamiento y las causas de abandono del tratamiento. Se analizaron 12/13 cuestionarios, con un total de 538 pacientes activos. La mayoría de los pacientes eran varones (85,5%) de 18 a 34 años (70%). El 40% eran usuarios de drogas intravenosas y el 25% admitió compartir agujas. Entre las comorbilidades asociadas con el consumo de heroína se encontró la enfermedad mental (48%), la hepatitis C (8,7%) y la infección por el VIH (2%). La comorbilidad psiquiátrica se asocia más con los pacientes que acuden al sector privado (el 69,8 frente al 29,7%; p < 0,03). La media de la dosis inicial de metadona es 25,3 ± 8,9 mg/día y las dosis de mantenimiento van de 41 a 80 mg/día. La falta de articulación con atención primaria fue una barrera más sentida que los problemas con la cobertura del seguro médico y los prejuicios del tratamiento con metadona (p < 0,05). También, los problemas administrativos y de la aseguradora (p < 0,003), la falta de suministro de metadona (p < 0,018) y la recaída en el consumo (p < 0,014) son las razones más significativas de abandono del tratamiento. Estos programas tienen diferentes niveles de desarrollo e implementación en los protocolos de tratamiento. Algunas de las barreras de acceso y de las causas de abandono del tratamiento pueden mitigarse mejorando la administración de salud." @default.
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• W3179357106 date "2019-04-01" @default.
• W3179357106 modified "2023-10-17" @default.
• W3179357106 title "Facing the growing heroin problem in Colombia: The new methadone-assisted treatment programmes" @default.
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• W3179357106 doi "https://doi.org/10.1016/j.rcpeng.2019.03.001" @default.
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