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methadone patient controlled

David D B Bates, Dorathy Tamayo-Murillo, Steven Kussman, Adam Luce, Christina A LeBedis, Jorge A Soto, Stephan W Anderson
PURPOSE: To determine whether the diameter of intrahepatic and extrahepatic bile ducts and pancreatic ducts in patients on methadone maintenance therapy is increased when compared with control subjects. METHODS: Between January 1, 2000 and March 15, 2013, a total of 97 patients (mean age 49.9, range 22-79, 65 male, 32 female) were identified who were receiving chronic methadone maintenance therapy (MMT) when they underwent imaging with abdominal MRI or a contrast-enhanced abdominopelvic CT...
October 21, 2016: Abdominal Radiology
Julie M Waldfogel, Suzanne Nesbit, Steven P Cohen, Sydney M Dy
Opioids remain the mainstay of treatment for severe cancer pain, but up to 20% of patients have persistent or refractory pain despite rapid and aggressive opioid titration, or develop refractory pain after long-term opioid use. In these scenarios, alternative agents and mechanisms for analgesia should be considered. This case report describes a 28-year-old man with metastatic pancreatic neuroendocrine cancer with severe, intractable pain despite high-dose opioids including methadone and a hydromorphone patient-controlled analgesia (PCA)...
October 18, 2016: Journal of Pain & Palliative Care Pharmacotherapy
Kam Lun Hon, Michael Ho Ming Chan, Ming Him James Ng, Chi Cheung Ho, Yin Ching Kathy Tsang, Wing Hung Tam, Chung Shun Ho
OBJECTIVE: Maternal drug abuse may influence neonatal outcomes. We compared neonatal outcomes of patients with urine screened positive for commonly abused drugs (CAD) versus those who were screened negative, and reviewed the pattern of drugs detected at a university teaching hospital. METHODS: Urine samples collected from babies with suspected illicit drug exposure who were admitted to the neonatal unit were sent for comprehensive drug screen (CDS) performed by liquid chromatography-time-of-flight mass spectrometry (LC-TOF/MS)...
October 10, 2016: Current Clinical Pharmacology
Mohammadali Nikoo, Nooshin Nikoo, Sanam Javid, Afshar Amiri, Marc Vogel, Fiona Choi, Amir Ali Sepehry, Amir Hooshang Bagheri Valoojerdi, Kerry Jang, Christian Schütz, Shahin Akhondzadeh, Michael Krausz
BACKGROUND AND AIMS: Recently, there has been a growing interest in using Opium Tincture (OT) for treating opioid dependence in certain regions. We aimed to assess the evidence on its safety and efficacy for this indication. METHODS: We searched several databases (CENTRAL, Medline, EMBASE, Web of Science, PsychINFO, ProQuest Dissertation & Theses Database, Iran Medex,, and with no language or publication date limitations. Two reviewers selected Randomized Controlled Trials (RCT), cohort /case-control/ cross-sectional studies and case-series on safety or efficacy of OT for treating opioid dependence and then extracted reported measures of mentioned outcomes from selected studies...
October 14, 2016: Addiction
Michel Landry, Nadia Veilleux, Julie-Eve Arseneault, Saneea Abboud, André Barrieau, Mathieu Bélanger
BACKGROUND: Methadone maintenance treatment programs implemented in Aboriginal communities have proven to be beneficial for the control of opioid addiction and its associated consequences, but the perceptions and opinions of different community members about these programs remain elusive. The goal of this study was to determine the perceptions of members of a First Nation community in New Brunswick, Canada, on the implementation of a methadone maintenance treatment program and its effects on the community...
July 2016: CMAJ Open
Xavier Castells, Ruth Cunill, Clara Pérez-Mañá, Xavier Vidal, Dolors Capellà
BACKGROUND: Cocaine dependence is a severe disorder for which no medication has been approved. Like opioids for heroin dependence, replacement therapy with psychostimulants could be an effective therapy for treatment. OBJECTIVES: To assess the effects of psychostimulants for cocaine abuse and dependence. Specific outcomes include sustained cocaine abstinence and retention in treatment. We also studied the influence of type of drug and comorbid disorders on psychostimulant efficacy...
September 27, 2016: Cochrane Database of Systematic Reviews
Matthew Randesi, Wim van den Brink, Orna Levran, Peter Blanken, Eduardo R Butelman, Vadim Yuferov, Joel Correa da Rosa, Jurg Ott, Jan M van Ree, Mary Jeanne Kreek
BACKGROUND: Heroin addiction is a chronic, relapsing brain disease. Genetic factors are involved in the development of drug addiction. The aim of this study was to determine whether specific variants in genes of the opioid system are associated with non-dependent opioid use and heroin dependence. METHODS: Genetic information from four subject groups was collected: non-dependent opioid users (NOD) [n=163]; opioid-dependent (OD) patients in methadone maintenance treatment (MMT) [n=143]; opioid-dependent MMT-resistant patients in heroin-assisted treatment (HAT) [n=138]; and healthy controls with no history of opioid use (HC) [n=153]...
September 5, 2016: Drug and Alcohol Dependence
Catherine E Myers, Janice Rego, Paul Haber, Kirsten Morley, Kevin D Beck, Lee Hogarth, Ahmed A Moustafa
This study adapts a widely-used acquired equivalence paradigm to investigate how opioid-addicted individuals learn from positive and negative feedback, and how they generalize this learning. The opioid-addicted group consisted of 33 participants with a history of heroin dependency currently in a methadone maintenance program; the control group consisted of 32 healthy participants without a history of drug addiction. All participants performed a novel variant of the acquired equivalence task, where they learned to map some stimuli to correct outcomes in order to obtain reward, and to map other stimuli to correct outcomes in order to avoid punishment; some stimuli were implicitly "equivalent" in the sense of being paired with the same outcome...
September 15, 2016: Behavioural Brain Research
Jennifer Horst, Melissa Frei-Jones, Elena Deych, William Shannon, Evan D Kharasch
BACKGROUND: Vaso-occlusive episodes (VOEs) are a significant source of morbidity among children and adults with sickle cell disease (SCD). There is little information on methadone use for SCD pain. This investigation evaluated methadone pharmacokinetics in children and adults with SCD, with a secondary aim to assess pain relief and opioid consumption. PROCEDURE: Participants included children (<18 years) and adults with a VOE requiring hospitalization. Patients were randomly assigned to receive standard care (opioid patient-controlled analgesia; control group) or one dose of intravenous methadone (0...
August 30, 2016: Pediatric Blood & Cancer
Sava V Petrov, Maria M Orbetzova, Yanko T Iliev, Doychin T Boyadzhiev
INTRODUCTION: Drug addictions to psychoactive substances are disorders with a complex bio-psycho-social genesis, which are characterized with chronic relapses. Substance addiction causes multifactorial damage to the normal functioning of individuals and requires a multicenter approach for the treatment process. AIM: The aim of the study was to assess the quality of life of patients undergoing chronic treatment with the opiate agonist methadone using a standardized questionnaire method in Bulgarian...
April 2016: Folia Medica
Alex Farr, Herbert Kiss, Michael Hagmann, Iris Holzer, Verena Kueronya, Peter W Husslein, Ljubomir Petricevic
BACKGROUND: Vaginal infections are a risk factor for preterm delivery. In this study, we sought to evaluate the vaginal flora of pregnant women receiving opioid maintenance therapy (OMT) in comparison to non-dependent, non-maintained controls. METHODS: A total of 3763 women with singleton pregnancies who underwent routine screening for asymptomatic vaginal infections between 10 + 0 and 16 + 0 gestational weeks were examined. Vaginal smears were Gram-stained, and microscopically evaluated for bacterial vaginosis, candidiasis, and trichomoniasis...
2016: BMC Pregnancy and Childbirth
J Haumann, J W Geurts, S M J van Kuijk, B Kremer, E A Joosten, M H J van den Beuken-van Everdingen
BACKGROUND: Cancer pain is still inadequately treated in up to 60% of cancer patients. Based on the additional effect on the N-Methyl-d-Aspartate receptor, we expected that methadone (Met) could provide better pain relief than fentanyl (Fen) in cancer pain with a neuropathic pain component. METHODS: A randomised controlled trial was performed with 52 strong opioids naive patients with head-and-neck cancer with substantial pain (pain Numerical Rating Scale [NRS] > 4) and a neuropathic pain component (Douleur Neuropathique [DN4] > 4)...
September 2016: European Journal of Cancer
Tanja Fusi-Schmidhauser, Donata Bardelli
The numb chin syndrome is a rare manifestation of intractable pain in the palliative care setting and represents a major therapeutic challenge. The reported etiologies of the numb chin syndrome include trauma, infections, immune-mediated systemic conditions, and malignancy, both through local infiltration or compression of the inferior alveolar nerve sheath. The authors present the case of a patient with long-standing multiple myeloma, suffering from numb chin syndrome caused by a spontaneous osteonecrosis of the jaw after bisphosphonate therapy...
September 2016: Journal of Pain & Palliative Care Pharmacotherapy
Jemima A Frimpong, Thomas D'Aunno, Stéphane Helleringer, Lisa R Metsch
BACKGROUND: To examine the extent to which state adoption of the Centers for Disease Control and Prevention (CDC) 2006 revisions to adult and adolescent HIV testing guidelines is associated with availability of other important prevention and medical services. We hypothesized that in states where the pretest counseling requirement for HIV testing was dropped from state legislation, substance use disorder treatment programs would have higher availability of HCV testing services than in states that had maintained this requirement...
2016: BMC Public Health
S Tolomeo, S Gray, K Matthews, J D Steele, A Baldacchino
BACKGROUND: Chronic opioid exposure, as a treatment for a variety of disorders or as drug of misuse, is common worldwide, but behavioural and brain abnormalities remain under-investigated. Only a small percentage of patients who receive methadone maintenance treatment (MMT) for previous heroin misuse eventually achieve abstinence and studies on such patients are rare. METHOD: The Cambridge Neuropsychological Test Automated Battery and T1 weighted magnetic resonance imaging (MRI) were used to study a cohort of 122 male individuals: a clinically stable opioid-dependent patient group receiving MMT (n = 48), an abstinent previously MMT maintained group (ABS) (n = 24) and healthy controls (n = 50)...
October 2016: Psychological Medicine
Amparo Carreras Alabau, José A Carrobles Isabel, Carmen Almendros Rodríguez
BACKGROUND: Stress is a known risk factor in addiction relapse, and prior studies show that relapse induced by stress may be more likely than drug-cue induced relapse. The main goal of our research was to establish the influence of perceived stress in methadone withdrawal outcome and the psychological factors involved. METHOD: A sample of 81 methadone maintenance treatment outpatients was evaluated and then observed during methadone dose reduction. RESULTS: a multivariate analysis first showed that successful detoxification was predicted by perceived stress, patient-clinic staff agreement, pharmacotherapy support and social care; and second, perceived stress was predicted by anxiety, depression, self-control, social care and benzodiazepine use...
August 2016: Psicothema
Eduardo J Pedrero-Pérez, Grupo MethaQoL
The effectiveness of methadone maintenance treatment is beyond any doubt, but there remains some incertitude about the appropriate and effective dosage and the objectives that should be achieved by this therapy. Some authors maintain that only doses higher than 50-60 mg/day ought to be considered effective, since only these block all the opioid receptors. But others propose the use of doses adjusted to the needs of the patient, based on their recovery process. Quality of life, satisfaction with treatment, psychopathological symptoms, cognitive performance and additional intake of illegal and unprescribed drugs were evaluated in a representative sample of all patients treated with opioid agonists in the Addiction Institute of Madrid (N = 1898, n = 450) and the Junta de Extremadura (N = 100, n = 65)...
June 14, 2016: Adicciones
Ferigol Fallah, Abolhasan Hamidikenari, Seyed Navid Sajadi, Seyed Rohollah Sajadi, Mohammadreza Shiran
BACKGROUND: Clopidogrel is a prodrug that converts in the liver to an active thiol metabolite, which irreversibly inhibits the platelet P2Y12 adenosine diphosphate receptor. It seems that methadone as CYP2C19 inhibitor affects ticlopidine activity in vivo. This study aimed to test the ability of methadone in changing ticlopidine pharmacokinetics. METHODS: We conducted a case-control study in 10 subjects. The cases (5 subjects) in our study were addicts who were receiving methadone maintenance treatment (MMT) for preventing opium withdrawal symptoms...
2016: Caspian Journal of Internal Medicine
Josep Porta-Sales, Cristina Garzón-Rodríguez, Christian Villavicencio-Chávez, Silvia Llorens-Torromé, Jesús González-Barboteo
INTRODUCTION: Most clinical reports on methadone rotation describe outcomes in hospitalized patients. The few studies that have included outpatients are retrospective. The aim of this study was to assess the efficacy and safety of methadone as a second-line opioid in adult patients with advanced cancer after rotation in routine clinical practice at a palliative care outpatient clinic. PATIENTS AND METHODS: This was a prospective, open-label study of 145 patients whose treatment was rotated from other opioids to methadone...
August 2016: Oncologist
Mark J Elzey, Sarah M Barden, Eric S Edwards
BACKGROUND: Opioid overdose continues to be a significant and growing cause of preventable mortality and morbidity. Studies suggest that unintentional, non-fatal overdose from prescription opioid analgesics constitutes a large portion of total overdose events. The societal burden associated with these events is a frequently overlooked public health concern. OBJECTIVES: To evaluate unintentional, non-fatal prescription opioid overdoses, including the identification of risk factors, societal burden, and knowledge gaps where further study is warranted...
May 2016: Pain Physician
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