Changes in mental health during opiate replacement therapy: A systematic review

Citation

Fingleton NA, Matheson C & Jaffray M (2015) Changes in mental health during opiate replacement therapy: A systematic review. Drugs: Education, Prevention, and Policy, 22 (1), pp. 1-18. https://doi.org/10.3109/09687637.2014.899986

Abstract
Aim: To determine whether changes in mental health occur over the course of opiate replacement therapy (ORT). Methods: Medline, Embase, PsycINFO, CINAHL and the Cochrane Library were searched from 1996 to 2011. Reference lists of identified reviews were hand-searched. Randomized controlled trials (RCTs) and national cohort studies which measured an aspect of mental health at baseline and follow-up, and reported significance testing over time, for individuals receiving ORT were included. Double data extraction was conducted. Findings: Twenty-two studies comprising 19 RCTs and three national cohort studies were included. Nineteen different instruments measuring various aspects of mental health were identified. Mental health significantly improved for all groups receiving ORT in 14 studies in either some or all of the domains assessed. There was tentative evidence to suggest methadone is less effective at improving mental health than other types of ORT. Improvements occurred early in the treatment process and were not always sustained. Conclusions: Mental health generally improves during ORT but this improvement may not continue beyond 12 months. Standardization of tools is recommended following comparative assessment of the sensitivity and specificity of different measures. © 2015 Informa UK Ltd. All rights reserved.

Journal
Drugs: Education, Prevention, and Policy: Volume 22, Issue 1