In addition to retention in treatment, compliance with treatment is an increasing challenge in SUD treatment and are not consistent across different levels of care [Borson, Arnevik, Rand-Hedricksen, Duckert, 2013]. Treatment non-compliance is not only limited to failure of the planned treatment and extends to cover non-concordance with the rules and specifics of the treatment provisions. In this context, a common example of non-compliance in OAT would be diversion and illegal distribution, and may lead to overdose and fatalities [WHO, 2009]. Diversion and abuse are marked with significant social and medical hazards (Yokell, Zaller, Green Rich, 2011).
In a physician’s review on diversion in OAT using BUP, abuse, via other than the standard …show more content…
Despite non-conclusive evidence, several factors were, consistently reported to have a positive correlation with dropouts. These factors include young age, psychiatric disorders, distress intolerance and impulsivity [Mancino, Curran, Han, Alle, Humphreys, Booth, 2010]. Equivocal reports on the impact of depression and anxiety on retention rates exist. For example, in a longitudinal outcome study (Australian Treatment Outcome Study), patients with depression observed lower retention and reported lower abstinence [Teesson et al, 2006]. This finding was, not replicated in 2,300 patients analysed for the correlation of depression or anxiety with treatment outcomes [Mancino, Curran, Han, Alle, Humphrys Booth, 2010]. Severe psychiatric illness is one of the factors that is highly associated with high dropouts. Other factors, including the severity of SUD and the associated social harm, measured by the expense of obtaining heroin, were also associated with high dropout rates [Lin et al, 2013]. Moreover, multiple substances of use and treatment episodes in addition to criminal behaviour are associated with higher dropout rates [Gossop, Marsden, Steward, Kiddal, 2003; Havard, Teeson, Darke, Ross,
In a physician’s review on diversion in OAT using BUP, abuse, via other than the standard …show more content…
Despite non-conclusive evidence, several factors were, consistently reported to have a positive correlation with dropouts. These factors include young age, psychiatric disorders, distress intolerance and impulsivity [Mancino, Curran, Han, Alle, Humphreys, Booth, 2010]. Equivocal reports on the impact of depression and anxiety on retention rates exist. For example, in a longitudinal outcome study (Australian Treatment Outcome Study), patients with depression observed lower retention and reported lower abstinence [Teesson et al, 2006]. This finding was, not replicated in 2,300 patients analysed for the correlation of depression or anxiety with treatment outcomes [Mancino, Curran, Han, Alle, Humphrys Booth, 2010]. Severe psychiatric illness is one of the factors that is highly associated with high dropouts. Other factors, including the severity of SUD and the associated social harm, measured by the expense of obtaining heroin, were also associated with high dropout rates [Lin et al, 2013]. Moreover, multiple substances of use and treatment episodes in addition to criminal behaviour are associated with higher dropout rates [Gossop, Marsden, Steward, Kiddal, 2003; Havard, Teeson, Darke, Ross,