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Are methadone counselors properly equipped to meet the palliative care needs of older adults in methadone maintenance treatment? Implications for training
- Author:
- DOUKAS Nick
- Journal article citation:
- Journal of Social Work in End-of-Life and Palliative Care, 10(2), 2014, pp.186-204.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia
Today's methadone patients differ greatly from those of the past. Because of the rise of polydrug use and the HIV and hepatitis epidemics, treatment has become much more complex, which multiply the concerns and complexities of treatment. Patients entering methadone programmes are also more commonly presenting at ages well into their 50s, 60s, and 70s; and this phenomenon of high rates continues to grow. The majority of these individuals in treatment have presented with a number of significant comorbid medical conditions that will progress and eventually lead to death. This ageing cohort must be approached with a modified treatment plan that focuses on management and promoting healthy aging, while attending to their maximum delay of illness, disease, and disability. This article argues that it is necessary for counsellors working with this group to adopt a palliative care philosophy. This article also makes recommendations in areas that counsellors need to be knowledgeable and skilled in to provide appropriate palliative services specific to this ageing population with multiple needs as they near end of life. (Edited publisher abstract)
Older adults in methadone maintenance treatment: a literature review
- Author:
- DOUKAS Nick
- Journal article citation:
- Journal of Social Work Practice in the Addictions, 11(3), July 2011, pp.230-244.
- Publisher:
- Taylor and Francis
- Place of publication:
- Philadelphia, USA
Approximately 10% of patients engaged in a methadone programme across the world are 50 years of age or over, and older people present challenges to clinics that prescribe methadone because of their unique biopsychosocial needs. This article reviews the research literature on methadone maintenance treatment or opioid replacement therapy, focusing on studies conducted with adults aged 50 or older who have been prescribed methadone. It describes the methods used and discusses the research identified, covering mortality and causes of death, medical and mental health issues, illegal drug use, social supports, barriers to treatment, and gender differences. It also discusses gaps in the research and makes recommendations for future studies. The article notes that there are a significant number of older adults in methadone maintenance treatment, but that there is limited research available, with few qualitative studies conducted so far.