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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2007 Jan 1;98(1):33–36. [Article in French] doi: 10.1007/BF03405382

Rétention en traitement et évolution de la clientèle d’un programme montréalais de substitution à la méthadone à exigences peu élevées

Michel Perreault 18,✉, Marie-Christine Héroux 28, Noé Djawn White 28, Pierre Lauzon 38, Céline Mercier 48, Michel Rousseau 58
PMCID: PMC6975673  PMID: 17278675

Abstract

Objectives

To evaluate client treatment retention and evolution in terms of living conditions, atrisk behaviours, and the use of psychoactive substances (PAS) over a one-year period, following admission into a low-threshold methadone program in Montreal.

Method

Individual interviews were administered to 114 clients from Relais-Méthadone (RM) at admission and one year after treatment initiation. Participants reported on PAS consumption and unsafe practices of drug use and sexual behaviours at high risk for transmission of HIV, sexually transmitted infections (STI) and other blood-borne viruses (BBV). Services utilized by clients were documented from Relais-Méthadone files. Bivariate analyses were used to compare data recorded at admission and one-year follow-up.

Results

The treatment retention rate after one year at RM was 64%. However, by taking into account those clients who were transferred to a regular program during the study period, as well as those who voluntarily tapered their methadone treatment (16.7%), the status of 80.7% of clients demonstrated improvement one year after admission into treatment. Furthermore, the clients who remained in treatment for a year for whom information was available (n=60) showed a tendency towards more stable living conditions. They also demonstrated a significant decrease in both the number of PAS injections and in risky behaviours related to drug consumption. A statistically significant decrease in the frequency of heroine and cocaine use was also observed. By contrast, however, two thirds of the individuals in treatment after a year (n=42) maintained or increased their daily consumption of other PAS.

Discussion

The treatment retention rate is comparable to other low or regular threshold substitution programs. The results support previous studies showing that the methadone substitution treatment reduces heroine and cocaine consumption, and decreases the number of unsafe behaviours that could potentially transmit HIV, STI and BBV for the majority of clients who remained in treatment. Future research could focus attention on people who abandon treatment and those who present at-risk behaviours during treatment.

MeSH terms: Methadone, low threshold programmes, harm reduction, public health

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