Use of methadone therapy at the Institute for Alcoholism and Drug Addiction in the Canton of Sarajevo

INTRODUCTION: Number of addicts increased in our country, especially after the war, and needed adequate solution of the problem as well as use of the experiences from the other countries that faced before us "epidemy" of addictions. One of the solutions for harm reduction caused by use of opioid substances, primarily heroin, is use of methadone (heptanone), which is a good pharmacological replacement. METHODS: In this paper we have presented one-year experience in application of methadone for detoxification or substitution among the patients in our Institute. This retrospective-prospective study included 104 patients treated by methadone detoxification therapy and 59 patients included in the program of methadone substitution. This study involves analyses of the applied therapy compared to age, gender, profession, and duration of addiction, employment status and other social and demographic indicators. RESULTS: Methadone detoxification therapy. Among all age groups most dominant are addicts age 21-30 years (71%), and some in the age group 30-35 years (18%). Lack of adequate treatment programs, as well as break in continuity of treatment due to the war in our country, caused that we have in our sample 10% patients older than 36 years. Few patients younger than 20 years of age, we can explain with short working age of your department, but even now we can notice the incensement of young addicts number. First contact with the drug our addicts usually have between 13 and 18 years of age (61%), while earliest age of contact was 11. Duration of addiction is usually from 1 up to 9 years (65%), although we cannot neglect the number of addicts who are using the drug more than 10 years (35%). During our work, up to now, we did not have neither one case of HIV infection, which does not means that this disease is not present in the addicts population that we have not tested yet. Number of Hepatitis B and C positive addicts in our sample is in accordance with epidemiological data from other countries. There was 32% Hepatitis B positive, 58% Hepatitis C positive, and 23% Hepatitis B and C positive. Methadone substitution therapy. Among those included in the MST, male patients are most dominant, with average age of 31.4 years. Majority of patients has finished high school, they are unemployed, single, and living with their parents. First contact with drugs they had in average age of 16.4 years, while the duration of use had mean value of 10 years. Initial maintenance doses were between 10 and 50 mg, mean 36.1 mg, and maintenance doses after the two months had mean value of 61.6 mg. Among patients involved in MST, we have noted one HIV positive case, and significantly larger number of patients that are positive on Hepatitis: Hepatitis C 33%, and Hepatitis B and C (34%). CONCLUSIONS: Our experience during the application of both treatment types is positive. This treatment is well accepted by the addicts. The MDT and MST methods provides better functioning, easier follow up and better participation in the social and psychological therapeutic processes, which are conducted at our department. Positive improvement in social functioning. Better motivation for the continuation of treatment in the other institutions (therapeutic community). We did not have any side effects of the treatment in order to stop the therapeutic process. We need continuous education and sensibility of the whole society and political community in order to accept, finance and maintain methadone programs.