Tuesday, December 30, 2008


A study from Australia assessed satisfaction among maintenance patients receiving either methadone (78%) or buprenorphine (22%) maintenance. Extremely stringent limits on “take-homes” were the major cause of dissatisfaction. Only 41% knew the “complaint procedure” for clinic patients. The results are interesting, but what is perhaps most thought-provoking for providers in US and elsewhere is that the study was done. While some “programs” do study patient satisfaction, most don’t; significantly, this report is of a special investigational study, rather than the results of routine satisfaction monitoring procedures. Full report: Madden et al. Drug Alc Rev Nov. 2008, vol 27, 671-678.


At 8:51 AM, Anonymous Anonymous said...

Patients, in my experience, are rarely sought for their opinions on treatment and even when they are their views are usually disregarded.I believe that the only way drug users will have their voice heard is by pulling together and creating local user forums to ensure they have a greater role in the delivery of treatment. They should also not be afraid to complain when the standards of care, by those who provide their treatment, fall short of best practice. And Finally, and most importantly, no patient should be treated unethically or disrespectfully or be made feel in some way undeserving of treatment because they are a drug user.

At 12:59 PM, Blogger RGNewman, MD said...

I agree with our Irish colleague, and would add that ultimately the prerequisite to patient "power" will rest in the ability to choose among treatment providers. If there's only one source of a life-and-death treatment in town, then no way will patients prevail. Sure, some providers, even when holding a monopoly, will be responsive and act on what they sincerely believe to be patients' best interest, but... remember the wise observation by Supreme Court Justice Louis Brandeis: "Experience should teach us to be most on our guard to protect liberty when the Government's purposes are beneficent... The greatest dangers to liberty lurk in insidious encroachment by men of zeal, well-meaning but without understanding." And what's true to "Government" applies at least as much to providers of addiction treatment.

At 1:36 AM, Anonymous Anonymous said...

i was a methadone patient once an i was treated different than other people,when i would go an get my daily dose at the chemist,when the chemist would be making my dose up he would stop an serve other people before me,the chemist treated me different than other paying customers an once when i said you where serving me 1st an you stopped an served 5 other people before me he said if i didnt like it go else where,so i had to put up with this for years an so did other people as we lived in a small town an the next town was 120km away

At 8:06 PM, Blogger RGNewman, MD said...

very sadly, the stigmatization of patients receiving methadone exists not only in the general community, but among healthcare providers as well, and that includes chemists ("pharmacists"). We understand and share your frustration - if there were a local pharmacy board or a govt body that licenses pharmacists (chemists), one might complain, but ultimately they have the upper hand and it's tough to win that battle. Sad, sad sad.


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