Patients' Anxiety Levels and Their Reactions Towards the Needed Adaptation of Policies in Methadone Maintenance Treatment Following the October 7th, 2023, Hamas Attack.

Abstract

Background: A war state followed the October 7th, 2003, Hamas vast attack on civilians and military in the southern part of Israel, requiring an immediate adaptation of the routine functioning of the methadone maintenance treatment (MMT) clinics - typically, through the expansion of the take-home dose (THD) policies.

Aim: To evaluate the level of anxiety and its relation to patients' satisfaction regarding THD expansion one month post-attack.

Methods: Of the 320 current patients in one MMT clinic, 297 (92.8%) were interviewed for anxiety (GAD-7) and rated whether the THD expansion benefited them (1 to 5). Substance in urine, sociodemographic, and addiction history details were taken.

Results: Of the participants, 35% were found to have no anxiety, 22.2% with mild, 21.9% with moderate, and 20.9% had severe anxiety. Logistic regression for anxiety found cocaine in urine and not opioids in urine (Odds Ratio (OR) = 3.6), history of having experienced physical violence (OR = 1.8), and not working (OR = 2.1) as risk factors. THD expansion benefited (scored ≥ 4) 82.2% of the responders, and in logistic regression for severe anxiety, not satisfied with THD expansion (OR = 2.9), being Israeli born (OR = 2.1), and not working (OR = 2.5) were included. Substance use did not change pre- and post-Hamas attack.

Conclusion: Most patients were satisfied with the THD expansion. However, severe anxiety levels characterized those who were not, emphasizing the need for anxiety monitoring to determine those patients. Additional intervention and augmenting these patients' frequency of visits to the clinic (instead of THD expansion) is recommended so they have further meetings with their therapist and reduce their anxiety.