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Addiction; methadone

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https://www.readbyqxmd.com/read/28767537/addressing-stigma-in-medication-treatment-of-adolescents-with-opioid-use-disorder
#1
Sarah M Bagley, Scott E Hadland, Brittany L Carney, Richard Saitz
: In September 2016, the American Academic of Pediatrics released a policy statement that adolescents with opioid use disorder should be offered pharmacotherapy with buprenorphine/naloxone, methadone, or naltrexone. In our clinical practice, however, we have encountered the perception among patients, families, and clinicians alike that medications should be used as a last resort. That we should wait until things get worse is a discarded approach. As addiction specialists, it is imperative that we prevent and identify risky use and use disorders, then intervene early and offer timely, evidence-based treatment...
August 1, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28765624/metacognitive-deficiency-in-a-perceptual-but-not-a-memory-task-in-methadone-maintenance-patients
#2
Saeedeh Sadeghi, Hamed Ekhtiari, Bahador Bahrami, Majid Nili Ahmadabadi
Drug addiction has been associated with lack of insight into one's own abilities. However, the scope of metacognition impairment among drug users in general and opiate dependent individuals in particular is not fully understood. Investigating the impairments of metacognitive ability in Substance Dependent Individuals (SDIs) in different cognitive tasks could contribute to the ongoing debate over whether metacognition has domain-general or domain-specific neural substrates. We compared metacognitive self-monitoring ability of a group of SDIs during methadone maintenance treatment (n = 23) with a control group (n = 24) in a memory and a visual perceptual task...
August 1, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28759635/intolerance-of-uncertainty-in-opioid-dependency-relationship-with-trait-anxiety-and-impulsivity
#3
Julia Garami, Paul Haber, Catherine E Myers, Michael T Allen, Blazej Misiak, Dorota Frydecka, Ahmed A Moustafa
Intolerance of uncertainty (IU) is the tendency to interpret ambiguous situations as threatening and having negative consequences, resulting in feelings of distress and anxiety. IU has been linked to a number of anxiety disorders, and anxiety felt in the face of uncertainty may result in maladaptive behaviors such as impulsive decision making. Although there is strong evidence that anxiety and impulsivity are risk factors for addiction, there is a paucity of research examining the role of IU in this disorder...
2017: PloS One
https://www.readbyqxmd.com/read/28745916/experiences-and-perceived-social-support-among-iranian-men-on-methadone-maintenance-therapy-a-qualitative-study
#4
Nader Aghakhani, Violeta Lopez, Michelle Cleary
The use of drugs predominantly among Iranian men leads to health and social problems. Iran has established methadone maintenance therapy centres but there is limited research exploring the experiences of men who make use of this therapy. The aim of this qualitative study was to explore the experiences of men on methadone maintenance therapy in Urmia, Iran. Sixteen opioid-dependent males on methadone syrup substitution therapy were interviewed. Transcribed data were subjected to thematic analysis. Three themes emerged from the data: (1) the role of family in drug addiction; (2) the role of environment in drug addiction; and (3) the support needed to overcome drug addiction...
July 26, 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28732367/significantly-more-intense-pain-in-methadone-maintained-patients-who-are-addicted-to-nicotine
#5
Lian-Zhong Liu, Lin-Xiang Tan, Yan-Min Xu, Xue-Bing Liu, Wen-Cai Chen, Jun-Hong Zhu, Jin Lu, Bao-Liang Zhong
Pain and cigarette smoking are very common in heroin-dependent patients (HDPs) receiving methadone maintenance treatment (MMT) and both have substantial negative effects on HDPs' physical and mental health. Nevertheless, very few studies have assessed the relationship between the two in HDPs. This study examined the association between pain intensity and smoking in Chinese methadone-maintained HDPs. A total of 603 HDPs were consecutively recruited from three MMT clinics in Wuhan, China, and administered with a socio-demographic and drug use questionnaire, a smoking questionnaire concerning average number of cigarettes smoked daily and Heaviness of Smoking Index, and Zung's Self-rating Depression Scale...
July 13, 2017: Oncotarget
https://www.readbyqxmd.com/read/28704148/-i-was-not-sick-and-i-didn-t-need-to-recover-methadone-maintenance-treatment-mmt-as-a-refuge-from-criminalization
#6
David Frank
BACKGROUND: Methadone Maintenance Treatment (MMT) in the United States (U.S.) has been undergoing a shift towards conceptualizing the program as recovery-based treatment. Although recovery is seen by some as a means to restore MMT to its rightful position as a medically-based treatment for addiction, it may not represent the experiences, or meet the needs of people who use drugs (PWUD), many of whom who use the program as a pragmatic means of reducing harms associated with criminalization...
July 13, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28699698/reduced-dosing-and-liability-in-methadone-maintenance-treatment-by-targeting-oestrogen-signal-for-morphine-addiction
#7
Yao-Chang Chiang, Ruey-Yun Wang, Chieh-Liang Huang, Shue-Hwa Chen, Wen-Jing Ho, Hsien-Yuan Lane, Ing-Kang Ho, Hwei-Ting Yang, Wen-Lung Ma
Methadone maintenance treatment (MMT) is the major tapering therapy for morphine addictive patients. There have gender differences reported in response to MMT. This study discovered that the estrogen-response element single nucleotide polymorphism (ERE-SNP; rs16974799, C/T) of cytochrome 2B6 gene (cyp2b6; methadone catabolic enzyme) responded differently to MMT dosing. Oestradiol was associated with high MMT dosing, high enantiomer (R- or S-) of 2-ethylidene-1,5-dimethyl-3,3-dipheny-pyrrolidine (EDDP; methadone metabolite) to methadone ratio and increased drug-seeking behaviour, implicating oestradiol-CYP-EDDP/methadone axis decreasing MMT efficacy...
July 12, 2017: Journal of Cellular and Molecular Medicine
https://www.readbyqxmd.com/read/28693573/a-qualitative-assessment-of-an-abstinence-oriented-therapeutic-community-for-prisoners-with-substance-use-disorders-in-kyrgyzstan
#8
Lyuba Azbel, Julia Rozanova, Ingo Michels, Frederick L Altice, Heino Stöver
BACKGROUND: Kyrgyzstan, where HIV is concentrated in prisons and driven by injection drug use, provides a prison-based methadone maintenance therapy program as well as abstinence-oriented therapeutic community based on the 12-step model called the "Clean Zone." We aimed to qualitatively assess how prisoners navigate between these treatment options to understand the persistence of the Clean Zone despite a lack of evidence to support its effectiveness in treating opioid use disorders. METHODS: We conducted an analysis of policy documents and over 60 h of participant observation in February 2016, which included focus groups with a convenience sample of 20 therapeutic community staff members, 110 prisoners across three male and one female prisons, and qualitative interviews with two former Clean Zone participants...
July 10, 2017: Harm Reduction Journal
https://www.readbyqxmd.com/read/28683227/supervised-injectable-heroin-a-clinical-perspective
#9
James Bell, Rob van der Waal, John Strang
BACKGROUND: Six recent randomised control trials (RCTs) have suggested that supervised injectable heroin (SIH) can be effective in patients who persist in street heroin use during methadone treatment. However, short-term randomised control trials have limitations in assessing the effectiveness of treatments for addictive disorders, which are chronic and relapsing disorders of motivation. These RCTs particularly fail to capture the process of the SIH treatment and the diversity of influence and change over time...
July 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28673521/addiction-consultation-services-linking-hospitalized-patients-to-outpatient-addiction-treatment
#10
Paul Trowbridge, Zoe M Weinstein, Todd Kerensky, Payel Roy, Danny Regan, Jeffrey H Samet, Alexander Y Walley
BACKGROUND: Approximately 15% of hospitalized patients have an active substance use disorder (SUD). Starting treatment for SUD, including medications, during acute hospitalizations can engage patients in addiction care. In July 2015, the Boston Medical Center Addiction Consult Service (ACS), began providing inpatient diagnostic, management, and discharge linkage consultations. We describe this implementation. METHODS: The ACS staff recorded SUDs diagnoses and medication recommendations and tracked follow-up data for affiliated outpatient office-based addiction clinics and methadone maintenance programs...
August 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28654734/can-a-rapid-measure-of-self-exposure-to-drugs-of-abuse-provide-dimensional-information-on-depression-comorbidity
#11
Eduardo Roque Butelman, Silvia Bacciardi, Angelo Giovanni Icro Maremmani, Maya Darst-Campbell, Joel Correa da Rosa, Mary Jeanne Kreek
BACKGROUND AND OBJECTIVES: Addictions to heroin or to cocaine are associated with substantial psychiatric comorbidity, including depression. Poly-drug self-exposure (eg, to heroin, cocaine, cannabis, or alcohol) is also common, and may further affect depression comorbidity. METHODS: This case-control study examined the relationship of exposure to the above drugs and depression comorbidity. Participants were recruited from methadone maintenance clinics, and from the community...
June 27, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28651618/relationships-between-received-and-perceived-social-support-and-health-related-quality-of-life-among-patients-receiving-methadone-maintenance-treatment-in-mainland-china
#12
Kaina Zhou, Hengxin Li, Xiaoli Wei, Juan Yin, Peifeng Liang, Hongmei Zhang, Lingling Kou, Mengmeng Hao, Lijuan You, Xiaomei Li, Guihua Zhuang
BACKGROUND: Social support has been considered one of the most important factors of health-related quality of life (HRQoL) evaluations among different populations; however, few studies have explored the relationships of both received and perceived social support to HRQoL among patients undergoing methadone maintenance treatment (MMT). Thus, the purpose of this cross-sectional study was to clarify these relationships. METHODS: Participants were patients admitted at the two largest privately and publicly funded MMT clinics in Xi'an...
June 26, 2017: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/28648162/-treatment-of-acute-pain-in-opioid-addicts
#13
Henrik Rindom, Jette Højsted, Nina Brünés
The challenge of managing acute pain in opioid-addicted patients is a question of fully understanding the pharmacological effects of the illegal drugs and to prevent overdosing or withdrawal symptoms. It requires a thorough knowledge of the patient's daily consumption of legal and illegal drugs and an understanding obtained through an accepting and empathetic communication with the patient. Substitution management aims to prevent opioid withdrawal symptoms and is not a means of managing pain. When planning the pain management the patient must receive at least 25% of the daily methadone dose, recalculated into equipotent substitute morphine...
June 26, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/28635521/assessment-of-an-innovative-voluntary-substance-abuse-treatment-program-designed-to-replace-compulsory-drug-detention-centers-in-malaysia
#14
Farrah Khan, Archana Krishnan, Mansur A Ghani, Jeffrey A Wickersham, Jeannia J Fu, Sin How Lim, Sangeeth Kaur Dhaliwal, Adeeba Kamarulzaman, Frederick L Altice
BACKGROUND: As part of an ongoing initiative by the Malaysian government to implement alternative approaches to involuntary detention of people who use drugs, the National Anti-Drug Agency has created new voluntary drug treatment programs known as Cure and Care (C&C) Centers that provide free access to addiction treatment services, including methadone maintenance therapy, integrated with social and health services. OBJECTIVES:   We evaluated early treatment outcomes and client satisfaction among patients accessing C&C treatment and ancillary services at Malaysia's second C&C Center located in Kota Bharu, Kelantan...
February 22, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28632076/association-of-oprd1-gene-variants-with-opioid-dependence-in-addicted-male-individuals-undergoing-methadone-treatment-in-the-north-of-iran
#15
Alireza Sharafshah, Hedyeh Fazel, Ali Albonaim, Vahid Omarmeli, Sajjad Rezaei, Ebrahim Mirzajani, Farzam Ajamian, Parvaneh Keshavarz
Genetic association of rs678849 along with neuroimaging and biomarker phenotypes, parallel with the known involvements of the OPRD1 in drug abuse, provided additional support for targeting these receptors as potential therapeutic targets in both neurodegenerative diseases and neuropsychiactric disorders such as Alzheimer's disease. Samples were selected among 202 opium-addicted participants undergoing methadone treatment and 202 healthy controls. Genomic DNA of all subjects was extracted from whole blood samples through a Salting Out procedure...
March 1, 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28611509/hepatitis-c-in-injection-drug-users-it-is-time-to-treat
#16
EDITORIAL
Alberto Grassi, Giorgio Ballardini
Injection drug users (IDUs) are at risk of hepatitis C virus (HCV) infection, due to needle and syringe sharing. Chronic HCV infection is a major cause of liver-related morbidity and mortality but can be cured with antiviral treatment leading to sustained viral response (SVR). It is well demonstrated that, when close cooperation between specialists in drug addiction and psychiatrists is assured, patients on maintenance treatment with methadone/buprenorphine can be treated for HCV with response rate, tolerability and side effects similar to those reported in non-IDUs...
May 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28586356/bidirectional-relationships-between-retention-and-health-related-quality-of-life-in-chinese-mainland-patients-receiving-methadone-maintenance-treatment
#17
Kaina Zhou, Duolao Wang, Hengxin Li, Xiaoli Wei, Juan Yin, Peifeng Liang, Lingling Kou, Mengmeng Hao, Lijuan You, Xiaomei Li, Guihua Zhuang
This study aimed to explore the bidirectional relationships between retention and health-related quality of life (HRQoL) in patients from mainland China receiving methadone maintenance treatment (MMT). This prospective cohort study recruited 1,212 eligible MMT patients from the two largest MMT clinics (one privately and another publicly funded) in Xi'an. This study started in March 2012 with a 2-year follow-up until March 2014. Retention was assessed by repeated terminations, past treatment duration, premature terminations, and follow-up treatment duration...
2017: PloS One
https://www.readbyqxmd.com/read/28571505/buprenorphine-implants-in-medical-treatment-of-opioid-addiction
#18
REVIEW
Steven Chavoustie, Michael Frost, Ole Snyder, Joel Owen, Mona Darwish, Ryan Dammerman, Victoria Sanjurjo
Opioid use disorder is a chronic, relapsing disease that encompasses use of both prescription opioids and heroin and is associated with a high annual rate of overdose deaths. Medical treatment has proven more successful than placebo treatment or psychosocial intervention, and the partial µ-opioid receptor agonist and κ-opioid receptor antagonist buprenorphine is similar in efficacy to methadone while offering lower risk of respiratory depression. However, frequent dosing requirements and potential for misuse and drug diversion contribute to significant complications with treatment adherence for available formulations...
August 2017: Expert Review of Clinical Pharmacology
https://www.readbyqxmd.com/read/28546740/new-developments-in-managing-opioid-addiction-impact-of-a-subdermal-buprenorphine-implant
#19
REVIEW
MariaLisa Itzoe, Michael Guarnieri
Opioid addiction to prescription and illicit drugs is a serious and growing problem. In the US alone, >2.4 million people suffer from opioid use disorder. Government and pharmaceutical agencies have begun to address this crisis with recently released and revised task forces and medication-assisted therapies (MAT). For decades, oral or intravenous (IV) MATs have helped patients in their recovery by administration of opioid agonists (methadone, buprenorphine, oxycodone), antagonists (naltrexone, naloxone), and combinations of the two (buprenorphine/naloxone)...
2017: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/28530896/use-and-misuse-of-opioid-agonists-in-opioid-addiction
#20
REVIEW
Vania Modesto-Lowe, Katie Swiezbin, Margaret Chaplin, Gabriela Hoefer
Although methadone (an opioid agonist) and buprenorphine (a partial opioid agonist) have evidence to support their use in treating opioid use disorder, they remain misunderstood and underutilized. In this article, we outline the risks and benefits of using these drugs as maintenance therapy in opioid-dependent patients.
May 2017: Cleveland Clinic Journal of Medicine
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