Successful adherence to observed prophylaxis and treatment of tuberculosis among drug users in a methadone program

Marc N. Gourevitch, William Wasserman, Maria S. Panero, Peter A. Selwyn

Research output: Contribution to journalArticlepeer-review

72 Scopus citations

Abstract

Incomplete antituberculous chemoprophylaxis and treatment are major causes of the resurgence of tuberculosis, often drug-resistant, among drug users. We offered directly observed antituberculous chemoprophylaxis (n = 102) or treatment (n = 12) to eligible methadone maintenance treatment patients. Methadone dosing was not contingent upon ingestion of antituberculous medication(s). No material incentives were provided. Ninety (88%) prophylaxis and 9 (75%) treatment patients were administered ≥ 5 weekly doses of antituberculous medications during ≥ 80% of 4740 patient-weeks. The majority of patients were HIV-seropositive. Active substance abuse was not associated with diminished adherence. Over 80% of patients completed or were still receiving therapy at the end of the study. Adherence to and completion of directly observed antituberculous therapy can thus be attained by drug users in treatment, despite ongoing drug misuse. Substance abuse treatment programs provide opportunities for enhanced compliance, and should thus be viewed as critical components of strategies to address the tuberculosis epidemic in drug users.

Original languageEnglish (US)
Pages (from-to)93-104
Number of pages12
JournalJournal of Addictive Diseases
Volume15
Issue number1
DOIs
StatePublished - 1996

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Clinical Psychology
  • Psychiatry and Mental health

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