Cited by 7Complementary and Alternative Medicine StudiesPharmacological Effects of Natural CompoundsSchizophrenia research and treatment

Conventional and unconventional treatments for stress among methadone-maintained patients: Treatment willingness and perceived efficacy

Open access
Barry, Declan T., Beitel, Mark, Breuer, Timothy, Cutter, Christopher J., Savant, Jonathan, Schottenfeld, Richard S., Rounsaville, Bruce J.·2010·The American Journal on Addictions

Abstract

We surveyed 150 methadone maintenance treatment (MMT) program patients about willingness to use, and perceived efficacy of, conventional and unconventional nonpharmacological stress-related treatments. Although levels of treatment willingness and perceived efficacy for both conventional and unconventional treatments were high, ratings for conventional interventions were, on average, significantly higher than those for unconventional ones. Dimensions of psychiatric distressa - but not demographic or MMT characteristicsa - predicted treatment willingness for conventional therapies and treatment willingness and perceived efficacy for unconventional therapies. These findings are likely to have implications for resource and program planning in MMT programs. © American Academy of Addiction Psychiatry.

Integrity signals

Registry

Crossref · 10.1111/j.1521-0391.2010.00109.x

Cites

31 of 31 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

8 of 23 cited sources checked · 5 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Only one published paper has examined MMT patients' attitudes toward unconventional medical treatment.

    “To our knowledge, only one published paper has examined MMT patients’ attitudes toward unconventional medical treatment.11”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [11] Luty, 2004, Treatment preferences of opiate-dependent patients, Psychiatr Bull. source

      The Method and Results (page unavailable) show that this paper examined opiate-dependent patients’ preferences among treatment options, including methadone; the Discussion describes some options as controversial. But the participants were not identified specifically as methadone maintenance treatment (MMT) patients, and the Discussion calls this one of a few UK studies, not the only published paper on the subject. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Premisecitation

    Opioid dependent patients often use a wide range of conventional and unconventional medical interventions.

    “opioid dependent patients often avail themselves of a wide range of conventional and unconventional medical interventions.1-3”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [1] Barry, 2009, Allopathic, complementary, and alternative medical treatment utilization for pain among methadone-maintained patients, Am J Addict. source

      The Results sections on allopathic and CAM pain treatment utilization report use of conventional medications and multiple complementary treatments. The study concerns pain relief among methadone-maintained patients with some or chronic severe pain; it does not establish the same pattern for opioid-dependent patients generally or for medical interventions unrelated to pain. Page numbers were not available in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
    • cites [2] Barry, 2008, Research-and community-based clinicians’ attitudes on treatment manuals, Am J Addict. source
    • cites [3] Wahlstrom, 2008, Use of mental health services and complementary and alternative medicine in persons with common mental disorders, Acta Psychiatr Scand. source
  • Findingown data

    Psychiatric distress dimensions predicted willingness to use conventional stress treatments.

    “Dimensions of psychiatric distress—but not demographic or MMT characteristics—predicted treatment willingness for conventional therapies and treatment willingness and perceived efficacy for unconventional therapies.”
    Quote in the paperSubstantial claim
  • Findingown data

    Psychiatric distress dimensions predicted willingness to use unconventional stress treatments.

    “Dimensions of psychiatric distress—but not demographic or MMT characteristics—predicted treatment willingness for conventional therapies and treatment willingness and perceived efficacy for unconventional therapies.”
    Quote in the paperSubstantial claim
  • Findingown data

    Willingness to use unconventional stress treatments was positively associated with perceived effectiveness of those treatments.

    “Higher levels of treatment willingness were associated with higher levels of perceived efficacy for both conventional (r = 0.86, p<0.01) and unconventional (r = 0.90, p<0.01) interventions.”
    Quote in the paperSubstantial claim
  • Classified as probably not a substantial claim. 13
  • May combine two claims. 16
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Prior investigations have highlighted the potential importance of massage therapy as a pain management strategy among MMT patients.

    “While prior investigations have highlighted the potential importance of examining massage therapy as a pain management strategy among patients seeking or already enrolled in MMT,1,29”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [1] Barry, 2009, Allopathic, complementary, and alternative medical treatment utilization for pain among methadone-maintained patients, Am J Addict. source
    • cites [29] Barry, 2009, Conventional and non-conventional pain treatment utilization among opioid dependent individuals with pain seeking methadone maintenance treatment: A needs assessment study, J Addict Med. source
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In that prior study, acupuncture was ranked thirteenth for perceived usefulness in assisting heroin use cessation.

    “acupuncture was ranked thirteenth.11”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [11] Luty, 2004, Treatment preferences of opiate-dependent patients, Psychiatr Bull. source
  • May combine two claims.

    Premisecitation

    Studies on unconventional medicine among substance-related disorder patients have yielded mixed efficacy findings and emphasized need for increased scientific rigor.

    “Generally, these studies have yielded mixed findings regarding the efficacy of unconventional medicine interventions and have emphasized the need for increased scientific rigor in evaluating these approaches.3,5-10”
    Quote in the paperNot a substantial claim1 of 7 sources checked
    • cites [3] Wahlstrom, 2008, Use of mental health services and complementary and alternative medicine in persons with common mental disorders, Acta Psychiatr Scand. source
    • cites [5] Boyen, 2008, Self-treatment of opioid withdrawal using kratom (Mitragynia speciosa korth), Addiction. source

      The Discussion (page not provided) says kratom’s long-term outcomes are unknown and calls for further research into its effects, pharmacology, and toxicology. That supports the need for more rigorous evaluation, but this paper reports a case of kratom self-treatment; it does not report mixed efficacy findings across unconventional medicine interventions. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [6] Jia, 2005, Neuroimaging studies of brain corpus striatum changes among heroin-dependent patients treated with herbal medicine, U’finer™ capsule, Addict Biol. source
    • cites [7] Jordan, 2006, Acupuncture treatment for opiate addiction: A systematic review, J Subst Abuse Treat. source
    • cites [8] Margolin, 2002, Interpreting conflicting findings from clinical trials of auricular acupuncture for cocaine addiction: Does treatment context influence outcome?, J Altern Complement Med. source
    • cites [9] Margolin, 2007, A preliminary study of spiritual self-schema (3-S) therapy for reducing impulsivity in HIV-positive drug users, J Clin Psychol. source
    • cites [10] Shaffer, 1997, Comparing Hatha yoga with dynamic group psychotherapy for enhancing methadone maintenance treatment: A randomized clinical trial, Altern Ther Health Med.
  • Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

    Premisecitation

    The importance of patient preferences in medical treatment decision-making is increasingly recognized.

    “While the importance of patient preferences in medical treatment decision-making is increasingly recognized,11,12”
    Quote in the paperNot a substantial claim2 of 2 sources checked
    • cites [11] Luty, 2004, Treatment preferences of opiate-dependent patients, Psychiatr Bull. source
    • cites [12] Say, 2003, The importance of patient preferences in treatment decisions-challenges for doctors, Br Med J. source
  • May combine two claims.

    Findingown data

    Among MMT patients, willingness to use and perceived effectiveness of both conventional and unconventional stress treatments were high.

    “Although levels of treatment willingness and perceived efficacy for both conventional and unconventional treatments were high”
    • Also stated in: § DISCUSSION · plain
      “Overall, MMT patients endorsed relatively high levels of treatment willingness and perceived efficacy for both conventional and unconventional treatments.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: MMT patients experience stress that warrants treatment.
  • May combine two claims.

    Findingown data

    Average ratings for conventional treatment willingness and perceived effectiveness were both 2.3 (SD=1.0).

    “Participants’ average ratings for conventional treatment willingness and the perceived efficacy of these interventions were 2.3 (SD = 1.0) and 2.3 (SD = 1.0), respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Among unconventional treatments, massage therapy was rated highest and hypnosis lowest for willingness.

    “On average, participants were most willing to try massage therapy as a stress-reduction treatment and were least willing to try hypnosis.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Among unconventional treatments, massage therapy was rated highest and hypnosis lowest for perceived effectiveness.

    “Similarly, on average, participants rated massage therapy and hypnosis as the highest and lowest in terms of perceived unconventional treatment efficacy, respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Among conventional treatments, nutrition/healthy food advice was rated highest and anger management lowest for perceived effectiveness.

    “Similarly, on average, participants rated nutrition or advice about healthy food choices and anger management as the highest and lowest in terms of perceived conventional treatment efficacy, respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Average ratings for unconventional treatment willingness and perceived effectiveness were 2.0 (SD=1.0) and 2.0 (SD=0.9), respectively.

    “Participants’ average ratings for unconventional treatment willingness and their perceived efficacy were 2.0 (SD = 1.0) and 2.0 (SD = 0.9), respectively.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    Among conventional treatments, nutrition/healthy food advice was rated highest and anger management lowest for willingness.

    “On average, participants were most willing to try nutrition or advice about healthy food choices as a stress-reduction treatment and were least willing to try anger management training.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductown data

    The instrument measuring treatment willingness and perceived efficacy was face-valid but not formally validated.

    “we developed an instrument, which although face-valid, has not been formally validated.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Completing the questionnaire at the treatment facility may have affected responses.

    “the questionnaire was completed at the treatment facility and this may have affected the responses of participants concerned about how staff might react to their responses.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The IPDS is an 11-item mini-structured interview assessing thoughts and feelings, used to assess personality disorder criteria.

    “The Iowa Personality Disorder Screen (IPDS;22) is an 11-item mini-structured interview that assesses respondents’ thoughts and feelings and was used in the current study to assess personality disorder criteria.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [22] Langbehn, 1999, The Iowa Personality Disorder Screen: Development and preliminary validation of a brief screening interview, J Personal Disord. source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The BSI-18 is an 18-item instrument designed to screen for psychiatric disorders, with depression, somatization, and anxiety subscales and a global severity index.

    “The Brief Symptoms Inventory 18 (BSI-18;21) is an 18-item instrument, designed to screen for psychiatric disorders, that contains 3 subscales: depression, somatization and anxiety, and a total global severity index (GSI) score.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [21] Derogatis, 2001 source
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationown data

    The study's findings are likely to have implications for resource and program planning in MMT programs.

    “These findings are likely to have implications for resource and program planning in MMT programs.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    Attitudes toward treatment willingness and perceived effectiveness are complex and have different psychiatric distress predictors.

    “Attitudes regarding treatment willingness and perceived efficacy are complex and are characterized by different psychiatric distress predictors.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The list of conventional and unconventional stress-reduction treatments given to participants was not exhaustive.

    “the list of examples of conventional and unconventional stress-reduction treatments that was provided to participants was not exhaustive.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductreasoning

    Participants self-selected, and it is unclear whether they differed from non-participants.

    “Participants self-selected for study participation; it is unclear if patients who enrolled in the study were different from those who did not.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductown data

    The questionnaire was pilot tested on research assistants, intake workers, and MMT patients and revised based on feedback.

    “pilot tested on 3 experienced research assistants, 5 seasoned intake workers, and 10 MMT patients using established guidelines, and revised based on pilot testing feedback.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Hypnosis and massage therapy have been well-studied and shown efficacy in clinical practice.

    “Hypnosis and massage therapy have been well-studied and have shown efficacy in clinical practice.27,28”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [27] Wootton, 2008 source
    • cites [28] Barry, 2008 source
  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Prior studies have documented high prevalence of diet-related chronic conditions among MMT patients and beneficial changes after nutritional counseling.

    “Prior studies have documented the high prevalence of chronic medical conditions related to poor diet among patients in MMT (e.g., diabetes) and the beneficial changes in diet, weight, and blood lipids following brief nutritional counseling and in consumption of saturated fats, fruits and vegetables following more intense counseling interventions.23-25”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [23] Fareed, 2009, Benefits of retention in methadone maintenance and chronic medical conditions as risk factors for premature death among older heroin addicts, J Psychiatric Prac. source
    • cites [24] Ockene, 1999, Effect of physician-delivered nutrition counseling training and an office-support program on saturated fat intake, weight, and serum lipid measurements in a hyperlipidemic population: Worcester Area Trial for Counseling in Hyperlipidemia (WATCH), Arch Intern Med. source
    • cites [25] Pignone, 2003, Counseling to promote a healthy diet in adults: A summary of the evidence for the US Preventive Services Task Force, Am J Prev Med. source
22 of 22
  • The paper relies on this without support.

    MMT patients experience stress that warrants treatment.

    “conventional and unconventional nonpharmacological stress-related treatments”
1 of 1

Statistics recomputed

Every reported test result, recomputed from its test statistic and degrees of freedom. A result shows as not adding up only once an independent check has confirmed it.

  • ConsistentF(3, 144) = 2.77reported p = .04 · recomputed p = .044

    “F (3, 144) = 2.77, p = .04”

  • ConsistentF(3, 145) = 4.9reported p = .003 · recomputed p = .003

    “F (3, 145) = 4.90, p = .003”

  • ConsistentF(3, 145) = 4.83reported p = .003 · recomputed p = .003

    “F (3, 145) = 4.83, p = .003”

  • ConsistentF(3, 144) = 2.41reported p = .069 · recomputed p = .069

    “F (3, 144) = 2.41, p = .069”

4 of 4

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Self-check results appear here once an independent check has confirmed them.

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Authors
Barry, D. T., Beitel, M., Breuer, T., Cutter, C. J., Savant, J., Schottenfeld, R. S., & Rounsaville, B. J.
Affiliations
  • Yale University (US)
  • APT Foundation (US)
Venue
The American Journal on Addictions
Publisher
Wiley
Published
2010-12
Volume
20
Issue
2
Pages
no-no
ISSN
1055-0496 (ISSN-L)
OpenAlex
W1560202644
Cited by
7
References
31
Citations by year
2024: 1 · 2023: 1 · 2020: 2 · 2014: 1 · 2013: 1
FWCI
1.94
Type
journal article
Language
en
Open access
Locations
  • American Journal on Addictions (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (submittedVersion)
Topics
  • Health Sciences › Medicine › Complementary and alternative medicine › Complementary and Alternative Medicine Studies
  • Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacological Effects of Natural Compounds
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
methadone maintenance treatment, stress, psychiatric distress, treatment willingness, perceived efficacy, non-pharmacological treatment, unconventional treatment, opioid use disorder
MeSH terms
Adult, Complementary Therapies, Attitude to Health, Cross-Sectional Studies, Female, Humans, Male

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Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-09-28.

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