PMH50 Differences Between Opioid Dependent Patients in Italy and Germany Receiving Substitution Therapy

Abstract

Objectives: Substitution therapy is commonly used across the world for the treatment of opioid dependence (OD), yet little evidence exists examining country-specific differences between acceptance and effectiveness of this treatment. The purpose of this study was to examine differences between patient demographics, treatment accessibility, and attitudes toward substitution therapy among OD patients in Germany and Italy. Methods: A telephonic survey, initiated by the Italian Federation of Operators of Dependences Departments and Services, examining substitution therapy was administered to OD patients across two countries: Germany (n=200) and Italy (n=378). The survey assessed experiences prior to and during substitution therapy. Results: Italian patients reported being in better physical and mental health than German patients (p < .001); were more likely to get information about substitution therapy from family members than German patients (8.9% vs. 3.2%, χ 2 = 5.22; p < .05); and were more likely to report that it was either very easy or fairly easy to find a doctor from whom they could receive substitution treatment than German patients (89.9% vs. 68.7%, χ 2 = 40.35; p < .001). In contrast, German patients were more likely to get information from other drug users (63.9% vs. 47.7%, χ 2 = 10.72; p < .01) or their family physicians (14.6% vs. 4.3%, χ 2 = 14.59; p < .0001), and were also more likely than Italian patients to misuse their substitution drug by either snorting (11.5% vs. 3.2%, χ 2 = 15.94; p < .0001) or injecting it (18.5% vs. 11.1%, χ 2 = 6.05; p < .05). Conclusions: The present results highlight key differences in patient attitudes and experiences regarding substitution therapy. Differences in social and institutional attitudes, in addition to cultural norms and health care policies, may explain the present findings, which demonstrate the complexity of the OD population.