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Evidence summaries

Methadone Maintenance Interventions in Reducing Illicit Opiate Use, HIV Risk Behaviour and Criminality

Methadonemaintenance therapy appears to have significant and favourable effect on illicit opiate use, criminal activities and HIV risk behaviour. Level of evidence: "B"

A systematic review 1 including 11 studies (2 056 subjects) with illicit opiate use as the outcome measure, 24 studies (7 173 subjects) with criminal activities as the outcome measure, and 8 studies (1 797+ subjects) with HIV risk behaviour as the outcome measure, was abstracted in DARE. There were significant and favourable effect on illicit opiate use, criminal activities and HIV risk behaviour. In a sample of opiate-dependent individuals in methadone treatment one could expect a 67% decrease in illicit opiate use, a 61% decrease in HIV risk behaviour, a 85% decrease in their drug-related criminal behaviour, and a 61% decrease in their drug- and property-related criminal behaviour, and a 58% decrease in their drug- and non-drug related criminal behaviours.

Comment: The quality of evidence is downgraded by limitations in review methodology. For an unknown reason, the authors had dropped six studies with non-significant results from their analysis of criminal behaviour to achieve homogeneity.

    References

    • Marsch LA. The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behavior and criminality: a meta-analysis. Addiction 1998 Apr;93(4):515-32. [PubMed] [DARE]

Primary/Secondary Keywords