Methadone‐Assisted Opiate Withdrawal and Subsequent Heroin Abstinence: The Importance of Psychological Preparedness

PHILIP MURPHY, STEVEN JONES, BARBARA JACK, JULIE KIRBY, Thomas Wilson

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Abstract

Background and Objectives: Treatment guidelines emphasize
patients’ readiness for transitioning from opiate substitution
treatment (OST) to opiate withdrawal and abstinence. Psychological
preparedness indicators for this transition were examined.
Methods: Patients (all male) were recruited from three treatment
settings: prison, an inpatient detoxification unit, and an outpatient
clinic. Time 1 (T1) was admission to methadone‐assisted
withdrawal in all settings. Time 2 (T2) was a 6‐month follow‐up.
With n = 24 at T1 for each group (N = 72), a battery of instruments
relevant to psychological preparedness was administered.
Results: At T1, inpatients had higher self‐efficacy beliefs for
successful treatment completion than prison patients. For patients
contactable at T2, T1 self‐efficacy positively predicted T2 opiate
abstinence. No other variable improved prediction. T1
SOCRATES (Stages of Change Readiness and Treatment
Eagerness Scale) ambivalence scores, age, and lifetime heroin
use duration predicted maintenance of contact or not with
treatment services and contactability by the researcher.
Measures of mood did not differ between groups at T1 or
predict T2 outcomes.
Discussion and Conclusions: Self‐efficacy beliefs are a potentially
useful indicator of readiness for transitioning from OST to a
medically assisted opiate withdrawal and subsequent abstinence.
Ambivalence regarding change, age, and lifetime heroin use
duration are potentially useful predictors of patients maintaining
contact with services, and of being retained in research.
Scientific Significance: These findings advance existing literature
and knowledge by highlighting the importance of self‐efficacy in
psychological preparedness for opiate abstinence, and the predictive
utility to clinicians of this and other variables measurable at
admission, in the clinical management of opiate users. (© 2020 The
Authors. The American Journal on Addictions published by Wiley
Periodicals LLC on behalf of The American Academy of Addiction
Psychiatry (AAAP);00:00–00)
Original languageEnglish
Pages (from-to)1-10
Number of pages10
JournalAmerican Journal on Addictions
VolumeTBD
Early online date19 May 2020
DOIs
Publication statusE-pub ahead of print - 19 May 2020

Keywords

  • Heroin
  • substance abuse

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