Why has treatment retention for methamphetamine decreased in the united states??
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Decreased Treatment Retention for Methamphetamine in the United States
Rising Methamphetamine Use and Its Impact on Treatment Retention
Increasing Methamphetamine Use Among Opioid Users
Methamphetamine use has been on the rise in the United States, particularly among individuals with opioid use disorder (OUD). This trend has significant implications for treatment retention. Studies have shown that methamphetamine use is associated with lower retention rates in medication-assisted treatment (MAT) programs for OUD. For instance, patients who used methamphetamine were found to have more than twice the relative hazards for treatment discharge compared to non-users. This suggests that methamphetamine use complicates the treatment process, making it harder for patients to stay in programs designed to help them overcome opioid addiction.
Socioeconomic and Demographic Factors
Several socioeconomic and demographic factors contribute to decreased treatment retention among methamphetamine users. Patients with lower educational attainment, younger age at treatment admission, and those with disabilities are less likely to complete treatment programs. Additionally, individuals who are unemployed or living in unstable housing conditions, such as homelessness, are also at higher risk of dropping out of treatment. These factors highlight the need for comprehensive support services that address not only the addiction but also the underlying socioeconomic challenges faced by these individuals.
Co-Use of Methamphetamine and Opioids
The co-use of methamphetamine and opioids further complicates treatment retention. Patients who co-use these substances have lower odds of completing short-term residential treatment compared to those who co-use opioids with other substances like alcohol or benzodiazepines. This group also tends to have higher rates of injection drug use and is less likely to receive medications for OUD, which are critical for successful treatment outcomes. The combination of these factors makes it particularly challenging to retain these patients in treatment programs.
Ineffectiveness of Current Medications
The effectiveness of medications for treating stimulant use disorders, including methamphetamine, in patients with co-occurring OUD is limited. Most medications studied for cocaine use disorder, which shares similarities with methamphetamine use disorder, have been found to be ineffective in improving treatment retention. This lack of effective pharmacological options further exacerbates the issue, as patients are less likely to stay in treatment programs that do not adequately address their methamphetamine use.
Regional Variations and Legal Supervision
Geographical variations also play a role in treatment retention. Methamphetamine use is more prevalent in certain regions of the United States, such as the Midwest, South, and West, where treatment admissions for methamphetamine use have significantly increased over the past decade. Additionally, patients under legal supervision tend to have higher completion rates and longer retention in treatment programs compared to those without legal supervision. This suggests that external accountability mechanisms, such as legal mandates, may help improve retention rates.
Conclusion
The decrease in treatment retention for methamphetamine users in the United States is a multifaceted issue influenced by rising methamphetamine use, socioeconomic and demographic factors, co-use of methamphetamine and opioids, the ineffectiveness of current medications, and regional variations. Addressing this issue requires a comprehensive approach that includes effective pharmacological treatments, supportive services to address socioeconomic challenges, and external accountability mechanisms to improve retention rates. Efforts to mobilize public health prevention, treatment, and response strategies are crucial to address the rising methamphetamine use and improve treatment outcomes for affected individuals.
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Most relevant research papers on this topic
Association between methamphetamine use and retention among patients with opioid use disorders treated with buprenorphine.
Methamphetamine treatment: trends and predictors of retention and completion in a large state treatment system (1992-2002).
A systematic review and meta-analysis of medications for stimulant use disorders in patients with co-occurring opioid use disorders.
Adults With Opioid and Methamphetamine Co-use Have Lower Odds of Completing Short-Term Residential Treatment Than Other Opioid Co-use Groups: A Retrospective Health Services Study
The impact of methamphetamine/amphetamine use on receipt and outcomes of medications for opioid use disorder: a systematic review
Retention of patients in opioid substitution treatment: A systematic review
Resurgent Methamphetamine Use at Treatment Admission in the United States, 2008-2017.
Correlates of Outpatient Drug Treatment Drop-Out Among Methamphetamine Users
Residential Treatment of Methamphetamine Users: Correlates of Drop-Out from the California Alcohol and Drug Data System (Cadds), 1994–1997
Oxytocin-enhanced motivational interviewing group therapy for methamphetamine use disorder in men who have sex with men: study protocol for a randomized controlled trial
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