			Home About us Contact

Methadone Use (methadone + use)

Distribution by Scientific Domains

Medical Sciences	80%

Selected Abstracts

Use of non-prescribed methadone and other illicit drugs during methadone maintenance treatment

DRUG AND ALCOHOL REVIEW, Issue 1 2000
Dr. DAVID BEST
Abstract Patterns of illicit and non-prescribed drug use among a cohort of 100 patients in methadone maintenance treatment were tracked over a 6-month period. While there were no statistically significant changes in alcohol or heroin use, there were significant increases in the frequency of crack cocaine and cannabis use. Use of non-prescribed methadone had also increased. Twenty-one percent reported non-prescribed methadone use at follow-up who had not done so at the first interview, with increases also in the mean quantities used. Non-prescribed methadone use at the second interview was strongly associated with the amounts of both methadone and diazepam prescribed at each of the data collecting points. [source]

Incarceration and drug use patterns among a cohort of injection drug users

ADDICTION, Issue 1 2009
Kora DeBeck
ABSTRACT Aims Drug law enforcement remains the dominant response to drug-related harm. However, the impact of incarceration on deterring drug use remains under-evaluated. We sought to explore the relationship between incarceration and patterns of drug use among people who inject drugs (IDU). Design Using generalized estimating equations (GEE), we examined the prevalence and correlates of injection cessation among participants in the Vancouver Injection Drug User Study followed over 9 years. In subanalyses, we used McNemar's tests and linear growth curve analyses to assess changes in drug use patterns before and after a period of incarceration among participants reporting incarceration and those not incarcerated. Findings Among 1603 IDU, 842 (53%) reported injection cessation for at least 6 months at some point during follow-up. In multivariate GEE analyses, recent incarceration was associated negatively with injection cessation [adjusted odds ratio (AOR) = 0.43, 95% confidence interval (CI) 0.37,0.50], whereas the use of methadone was associated positively with cessation (AOR = 1.38, 95% CI 1.22,1.56). In subanalyses assessing longitudinal patterns of drug use among incarcerated individuals and those not incarcerated over the study period, linear growth curve analyses indicated that there were no statistically significant differences in patterns of drug use between the two groups (all P > 0.05). Conclusions These observational data suggest that incarceration does not reduce drug use among IDU. Incarceration may inhibit access to mechanisms that promote injection cessation among IDU. In contrast, results indicate that methadone use is associated positively with injection cessation, independent of previous frequency of drug use. [source]

The role of methadone in cancer pain treatment , a review

INTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 7 2009
W. Leppert
Summary Background:, Methadone is an opioid analgesic of step 3 of the World Health Organization (WHO) analgesic ladder. Aim and Methods:, To outline pharmacodynamics, pharmacokinetics, drug interactions, equianalgesic dose ratio with other opioids, dosing rules, adverse effects and methadone clinical studies in patients with cancer pain. A review of relevant literature on methadone use in cancer pain was conducted. Results:, Methadone is used in opioid rotation and administered to patients with cancer pain not responsive to morphine or other strong opioids when intractable opioid adverse effects appear. Methadone is considered as the first strong opioid analgesic and in patients with renal impairment. Methadone possesses different pharmacodynamics and pharmacokinetics in comparison to other opioids. The advantages of methadone include multimode analgesic activity, high oral and rectal bioavailability, long lasting analgesia, lack of active metabolites, excretion mainly with faeces, low cost and a weak immunosuppressive effect. The disadvantages include long and changeable plasma half-life, high bound to serum proteins, metabolism through P450 system, numerous drug interactions, lack of clear equianalgesic dose ratio to other opioids, QT interval prolongation, local reactions when administered subcutaneously. Conclusions:, Methadone is an important opioid analgesic at step 3 of the WHO analgesic ladder. Future controlled studies may focus on establishment of methadone equianalgesic dose ratio with other opioids and its role as the first strong opioid in comparative studies with analgesia, adverse effects and quality of life taken into consideration. [source]

Experience of Methadone Therapy in 100 Consecutive Chronic Pain Patients in a Multidisciplinary Pain Center

PAIN MEDICINE, Issue 7 2008
FRCPC, Philip Peng MBBS
ABSTRACT Objective., The objective of the study was to describe the experience of methadone use in 100 consecutive chronic pain patients managed in a single multidisciplinary center. Design., A chart review of chronic pain patients on methadone therapy initiated at the Wasser Pain Management Center from January 2001 to June 2004. Setting, Patients, and Intervention., Outpatients receiving methadone for chronic pain management in a tertiary multidisciplinary pain center. Outcome Measure., Effects on pain relief and function, conversion ratio from other opioids, side effects, and disposition were reviewed. Results., Charts of 100 methadone patients (age 45 ± 11 years old; M/F: 3/7; duration of pain 129 ± 110 months) managed by five physicians and one nurse were reviewed. The main reason for the initiation of methadone therapy was opioid rotation (72%). The average oral morphine equivalent dose was 77 mg/day before methadone therapy, and the methadone dose after initial stabilization was 42 mg with no consistent conversion ratio observed. The mean duration of methadone therapy was 11 months. Most of the patients (91%) were taking concomitant adjuvant analgesics or psychotropic agents, mostly antidepressants and anticonvulsants. The average Numeric Verbal Rating Score before and after methadone treatment was 7.2 ± 1.7 and 5.2 ± 2.5 (P < 0.0001). Thirty-five patients discontinued their methadone treatment mainly because of side effects, ineffectiveness, or both. Conclusion., From our experience, methadone is an effective alternative to conventional opioids for chronic pain management when used by experienced clinicians in a setting that allows for close monitoring and careful dose initiation and adjustment. [source]

Methadone Reincarnated: Novel Clinical Applications with Related Concerns

PAIN MEDICINE, Issue 4 2002
Scott M. Fishman MD
Methadone has numerous advantages as an analgesic, which have supported its recent increase in use. However, methadone also has a pharmacological profile as an opioid that differentiates it from other, better known or more widely used opioids. It also has unusual pharmacodynamics, pharmacokinetics, and metabolism that must be considered for safe use of methadone as an analgesic. This review looks at the history of methadone use as an analgesic and its properties that distinguish it as an unusual, and potentially, unstable opioid. [source]