TY - JOUR AU - Rajaratnam, MD, Ranjit AU - Sivesind, PhD, David AU - Todman, PhD, McWelling AU - Roane, MD, David AU - Seewald, MD, Randy PY - 2018/01/30 Y2 - 2024/03/28 TI - The aging methadone maintenance patient: Treatment adjustment, long-term success, and quality of life JF - Journal of Opioid Management JA - J of Opioid Management VL - 5 IS - 1 SE - Articles DO - 10.5055/jom.2009.0004 UR - https://wmpllc.org/ojs/index.php/jom/article/view/922 SP - 27-37 AB - <strong>Objective:</strong> To evaluate the features and modes of adaptation to aging among Methadone Maintenance Treatment (MMT) enrollees.<br /><strong>Setting:</strong> Beth Israel Medical Center in New York City.<br /><strong>Participants:</strong> A sample of 156 MMT enrollees (103/66 percent males and 53/34 percent females) age 24-68 years. Twenty-nine percent of participants were aged 55 or older.<br /><strong>Design:</strong> A cross-sectional, multivariate, correlational design.<br /><strong>Outcome Measures:</strong> Participants were administered the MMSE, ASI, BSI, as well as measures of impulsiveness and quality of life (QOL).<br /><strong>Results:</strong> Older adults were more likely to have had longer periods of treatment (p &lt; 0.01), less likely to report current heroin use (p &lt; 0.05) and overall drug use (p &lt; 0.05), but were more likely to have a history of comorbid alcohol misuse (p &lt; 0.01). Advanced age was also associated with less impulsiveness, hostility, paranoia, and interpersonal sensitivity (p &lt; 0.01), more chronic medical problems (p &lt; 0.05), greater use of medication for medical problems (p &lt; 0.05), and more liberal take home medicine schedules (p &lt; 0.01). However, no differences were found between older and younger participants with respect to their scores on the Overall Social Support scale (p &gt; 0.05), the Personal Well-Being Index (p &gt; 0.05) and the Satisfaction with Life Scale (p &gt; 0.05), suggesting comparable levels of QOL. Furthermore, the rate of contact for older participants with medical professionals did not differ significantly from that of younger participants (p &gt; 0.05). Only 7.1 percent of older participants reported regular contact with a primary care physician; a rate that is slightly lower than the rate in the overall population.<br /><strong>Conclusions:</strong> The findings from the present study highlight at least two underappreciated challenges that clinicians are increasingly likely encounter in their work with the aging MMT population. These challenges are: (1) that despite numerous medical and psychiatric complaints, only a small proportion of MMT patients have regular contact with a primary care physician and the rate of contact does not appear to increase with age and (2) even with age-related declines in psychiatric comorbidity and illicit substance use, the suboptimal level of QOL that is characteristic of the MMT population as a whole does not improve with aging and length of tenure in MMT. ER -