addictive - modifying: agonist: effectiveness

Question 1

methadone

Answer 1

P: Methadone is effective in retaining patients in addiction treatment programs, which is a crucial factor in long-term recovery.
E: NICE reviewed 31 studies, including 27 randomized controlled trials, and found that methadone users had significantly higher retention rates compared to those receiving a placebo or no treatment at all. Additionally, methadone use correlated with lower rates of illicit opioid use.
T: This suggests methadone’s effectiveness, as higher retention rates mean patients are more likely to stay in treatment, reducing the risk of relapse and maintaining progress toward recovery. Therefore, methadone’s role in improving retention supports its effectiveness in opioid addiction treatment.
C: However, methadone treatment may lead to dependence itself, creating a reliance on another substance rather than promoting complete independence from opioids.

Question 2

attrition

Answer 2

P: A weakness is the issue of high attrition rates, which can bias study outcomes and make data ungeneralizable.
E: Research on methadone and naltrexone often shows high dropout rates, particularly among individuals who struggle most with adherence to treatment. Studies therefore tend to gather data only from individuals who successfully remain in the program
T: This is a weakness as it means that studies may overestimate the effectiveness of the treatments, as they only reflect the outcomes of individuals who can adhere to the program. Consequently, attrition creates a skewed sample that could make the treatment seem more effective than it truly is for the general population, limiting the generalizability of results.
C: Some might argue that even with attrition, the treatment’s impact on those who remain in the program is still meaningful and can provide insight into possible success for motivated individuals

Question 3

naltrexone

Answer 3

P: Naltrexone has been shown to reduce relapse rates in highly motivated patients when paired with close monitoring and additional support.
E: NICE reviewed 17 studies and they found that overall, naltrexone was associated with lower relapse rates for patients who were motivated and supported during treatment.
T: This suggests that naltrexone’s effectiveness is partially dependent on patient motivation and the support structures in place. In cases where patients are committed and have adequate support, naltrexone can be effective in preventing relapse, making it a viable option for specific patient groups.
C: On the other hand, naltrexone’s success relies heavily on patient motivation and consistent support, meaning it may not be effective for patients lacking these factors.