The 130th Annual Meeting of APHA

Abstract #41636

Bernard Cerutti, PhD, Mario Lazzaro, MD, and Ignazio Cassis, MD, MPH. Department of Public Health, Cantonal Public Health Office, Via Dogana 16, Bellinzona, 6501, Switzerland, +41 91 814 40 09, bernard.cerutti@ti.ch

Background: One of the worthy reporting facts about the methadone maintenance intervention policy in Ticino is that all the treatments, regulated by the narcotic laws, are handled by authorized family physicians.

Objective: To assess the local maintenance system and to evaluate the bio-psychosocial situation of the patients.

Methods: A prospective open end observational cohort study was initiated in February 2000 (n=700 patients), and all the new patients since then have been included. Treatment facts (physician, dose of methadone, other addictive use, psychosocial support, social and financial situation, education, reason for interruption) are collected through a two-page form filled by the physicians and the patients at the beginning of the treatment, every year, and whenever the treatment stops.

Intermediate results: An analysis was done on a subset of patients who initiated a treatment after January 2000 and with follow up available: after one year, the use of heroin has decreased significantly while the use of alcohol, cannabis, or cocaine has not significantly changed. Full-time or part-time activity (occasional job excluded) has increased by more than 12%.

Conclusion: The very first results suggest that the maintenance system managed by family doctors is original and worth considering. The patients state of health seems to have improved, though confirmatory results are needed. The cohort study will allow the authorities to identify the weaknesses of the treatment strategy and to better co-ordinate the medical education (two information and training sessions are held every year, where pharmacists and social workers are invited).

Learning Objectives:

• After attending the presentation or reading the poster, the participant will be able to describe the organization of a methadone maintenance network without treatment centers, define a short list of indicators used to assess a maintenance treatment policy, and evaluate some results and needs for improvement using comparison with the literature

Keywords: Methadone Maintenance, Public Health Policy

Related Web page: www.ti.ch/DOS/DSP/UffMC/mc/settori/tossico

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.