Study finds low opioid treatment adherence among homeless who experience mental illness

By Ian Bryce

A study by SFU researcher Milad Parpouchi found low adherence to methadone treatment among homeless people with mental illness and opioid addiction. The study—the first of its kind, which tracked program users over 15 years—conducted with colleagues in the Somers Research Group, found that methadone was accessed on an average of 47% of the days.

Methadone maintenance treatment (MMT) has been shown to reduce the use of illicit opioids, overdose and social problems for people experiencing opioid addiction. Adherence to MMT is important to prevent relapse and overdose.

The study found that:

• The level of adherence to methadone was very low with participants taking methadone 47% of the time.
• The rates of infectious diseases among participants were extremely high.
  • 19% of participants were living with HIV or AIDS
  • 71% were living with hepatitis C
    
• Even though all participants received methadone treatment, there were still high rates of substance use:
  • 58% used heroin
  • 81% used two or more substances

“We cannot divorce pharmacological interventions like methadone from the social environments that people live in,” says Milad Parpouchi, a Trudeau scholar, Canadian Institutes of Health Research doctoral scholar, and the study’s lead author. “We need to ensure that people’s basic needs and human rights are also being met.”

“It’s not a complete surprise that people who are homeless have a much more difficult time adhering to medication regimens—decent housing and appropriate health and social services need to be part of the solution,” he adds.

Parpouchi says that this research highlights the need for further attention to optimize MMT programs as part of a comprehensive approach to re-housing individuals like the participants in the study.

Read the Characteristics of adherence to methadone maintenance treatment over a 15-year period among homeless adults experiencing mental illness here.