Nicotine maintenance for smokers in methadone treatment: a new direction |
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| Authors: | Marcel A. de Dios Miguel Ángel Cano Ellen L. Vaughan Morgan M. McNeel Sarah Childress Raymond Niaura |
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| Affiliation: | 1. Department of Psychological, College of Education, Health, and Learning Sciences, University of Houston, Houston, TX, USA;2. Health Research Institute, University of Houston, Houston, TX, USA;3. Department of Epidemiology, College of Public Health and Social Work, Florida International University, Miami, FL, USA;4. Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, IN, USA;5. Department of Social and Behavioral Sciences, College of Global Public Health, New York University, New York, NY, USA |
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| Abstract: | Patients of methadone maintenance treatment (MMT) exhibit an exceedingly high prevalence of tobacco use and disproportionately suffer from tobacco-related illnesses and mortality. A number of studies have sought to target MMT smokers with cessation interventions utilizing a variety of behavioral and pharmacological treatments. Such efforts have struggled to attain even modest rates of cessation at follow-up, suggesting a need for novel approaches. In an effort to accelerate this area of research, the current article proposes an alternative paradigm for MMT smokers: Nicotine Maintenance. The proposed model emphasizes five domains aimed at advancing the contextual fit between smoking cessation treatment and MMT: (1) A harm reduction and maintenance orientation; (2) a reconsideration of abstinence-oriented frameworks and techniques; (3) a longer-term perspective; (4) greater integration with the MMT treatment milieu; and (5) approaches that address the unique needs of MMT patients including shame, stigma, and the enhancement of treatment autonomy. |
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| Keywords: | Methadone maintenance smokers harm reduction nicotine dependence opioid dependence |
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