APH 2005, 63, 67-84:

Supporting physicians caring for methadone users: the evaluation of the implementation of a Quebec program.

N. Touati PhD

Keywords: methadone treatment, treatment access, Quebec, support for health professionals,
                methadone-prescribing,  physicians, program implementation, program evaluation, vulnerable population,
                support,  health professionals

Subject of study: We evaluate the implementation of a Quebec program of support for professionals caring for methadone users (known as SAM: Services d’appui pour la méthadone). This program evaluation has two main objectives: to analyze the program implementation process and to assess the program dissemination and utilization (we focus on physicians).

Methods: First, three qualitative case studies have been used. Second, a survey was sent to all physicians prescribing methadone in Quebec (139 physicians), half of whom responded.

Findings: This study has highlighted the factors that have facilitated or inhibited the SAM implementation. In regard to the program dissemination, it appears that physicians do not know and use sufficiently the program. That said, most physicians find the support provided by the program to be of great importance. Nevertheless, they do not make a commitment to increase their availability to methadone users. Improving access and continuity of methadone treatment raises complex issues.