Carla Marienfeld, MD, Assistant Professor of Psychiatry, has published papers about methadone maintenance treatment in China, and teaching psychotherapy for opioid use disorders in China and Malaysia.
Her study about the use of methadone to treat drug users in Wuhan, China, a city of over 10 million people in central China, was published in the international journal Drug and Alcohol Dependence.
Only 25.8 percent of patients enrolled in the city’s 20 methadone dispensaries received 80 percent or more of their daily doses in treatment, according to the study, which also found that poor adherence to daily treatment correlated with continued use of opiates during treatment.
The findings prompted the Wuhan Centers for Disease Prevention and Control to implement new measures to improve the quality of methadone treatment in the city.
Current guidelines and treatment protocols were reviewed, training and supervision of doctors and nurses in the program was improved, and measures were taken to reduce the number of patients who miss their daily methadone treatment, according to the paper.
In her other paper, published in the journal Academic Psychiatry, Marienfeld studied the use of psychotherapy to help drug users in low- and middle-income countries, in this case China and Malaysia.
The approach used was Behavioral Drug and HIV-risk Reduction Counseling (BDRC), which the paper describes as “highly specialized, time limited counseling focusing on a specific set of problem areas typically experienced by individuals with opioid use disorder entering medication assisted treatments.”
The goal of BDRC is to improve the patient’s “knowledge, skills, and self-efficacy to support his or her long-term recovery efforts,” according to the paper.
In a randomized clinical trail in Malaysia, results showed that opiate positive urine samples were reduced in the BDRC group, according to the paper. In a separate clinical trial in China, participants in methadone treatment and BDRC achieved both greater reductions of HIV risk behaviors and use of opiates.
Marienfeld pursues research in global mental health and health services in addiction. She completed a fellowship in Addiction Psychiatry at Yale, and founded and leads the Yale Global Mental Health Program. Her clinical interests include opioid dependence and public psychiatry.