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Methadone

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https://www.readbyqxmd.com/read/28651404/-correlation-between-insufficient-methadone-dosage-and-morphine-positive-urine-on-drop-out-of-treatment-in-patients-with-access-to-methadone-maintenance-treatment
#1
T Yao, D Feng, M H Pan, Y P Cheng, C X Li, J Wang, Y L Feng, J Shi, T Su, Q Chen, S Shi, S P Wang
Objective: To estimate the incidence of drop out of treatment in patients with access to methadone maintenance treatment and explore the correlation and interaction between insufficient methadone dosage and morphine positive urine on the drop out in Guangxi Zhuang Autonomous Region. Methods: Face to face interview was conducted in 1 031 patients at 3 methadone maintenance treatment clinics in Guangxi. Results: The study included 1 031 participants, 40.6% of them (419/1 031) had stopped treatment. The drop out rates in urine morphine positive group and methadone dosage<100 mg/d group were 57...
May 10, 2017: Zhonghua Liu Xing Bing Xue za Zhi, Zhonghua Liuxingbingxue Zazhi
https://www.readbyqxmd.com/read/28650702/a-case-report-of-methadone-associated-hypoglycemia-in-an-11-month-old-male
#2
Michael S Toce, Margaret A Stefater, David T Breault, Michele M Burns
BACKGROUND: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported. We present the case of an 11-month-old male who developed hypoketotic, hyperinsulinemic, hypoglycemia after an acute, unintentional methadone exposure. CASE DETAILS: The patient was a previously healthy 11-month-old male who presented in respiratory failure...
June 26, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28650467/genome-wide-loss-of-function-genetic-screening-identifies-opioid-receptor-%C3%AE-1-as-a-key-regulator-of-l-asparaginase-resistance-in-pediatric-acute-lymphoblastic-leukemia
#3
S M Kang, J L Rosales, V Meier-Stephenson, S Kim, K Y Lee, A Narendran
L-asparaginase is a critical chemotherapeutic agent for acute lymphoblastic leukemia (ALL). It hydrolyzes plasma asparagine into aspartate and NH3, causing asparagine deficit and inhibition of protein synthesis and eventually, leukemic cell death. However, patient relapse often occurs due to development of resistance. The molecular mechanism by which ALL cells acquire resistance to L-asparaginase is unknown. Therefore, we sought to identify genes that are involved in L-asparaginase resistance in primary leukemic cells...
June 26, 2017: Oncogene
https://www.readbyqxmd.com/read/28648353/healthcare-contact-and-treatment-uptake-following-hepatitis-c-virus-screening-and-counseling-among-rural-appalachian-people-who-use-drugs
#4
Dustin B Stephens, April M Young, Jennifer R Havens
BACKGROUND: Hepatitis C virus (HCV) remains a major contributor to morbidity and mortality worldwide. Since 2009, Kentucky has led the United States in cases of acute HCV, driven largely by injection drug use in rural areas. Improved treatment regimens hold promise of mitigating the impact and transmission of HCV, but numerous barriers obstruct people who inject drugs (PWID) from receiving care, particularly in medically underserved settings. METHODS: 503 rural people who use drugs were recruited using respondent-driven sampling and received HCV screening and post-test counseling...
June 22, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28648162/-treatment-of-acute-pain-in-opioid-addicts
#5
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/28646524/risk-factors-for-severe-respiratory-depression-from-prescription-opioid-overdose
#6
Lindsay M Fox, Robert S Hoffman, David Vlahov, Alex F Manini
BACKGROUND AND AIMS: Prescription opioid overdose is a leading cause of injury-related morbidity and mortality in the US. We aimed to identify characteristics associated with clinical severity in emergency department patients with prescription opioid overdose. DESIGN: This was a secondary data analysis of adult prescription opioid overdoses from a large prospective cohort of acute overdoses. We examined elements of a typical emergency department evaluation using a multivariable model to determine which characteristics were associated with clinical severity, specifically severe respiratory depression (SRD)...
June 23, 2017: Addiction
https://www.readbyqxmd.com/read/28643437/silibinin-affects-the-pharmacokinetics-of-methadone-in-rats
#7
Pei-Pei Pan, Jun Wang, Jun Luo, Shuang-Hu Wang, Yun-Fang Zhou, Sai-Zhen Chen, Zhou Du
The aim of the present study was to investigate the pharmacokinetic effect of silibinin on methadone in rats. 24 male Sprague-Dawley rats were randomly divided into 4 groups: control group, single dose of 100 mg/kg group, multiple doses of 100 mg/kg group and multiple doses of 30 mg/kg group. A single dose of 6 mg/kg methadone was administrated to rats orally without or with silibinin. Plasma samples were collected via tail vein at different time points and concentrations of methadone and its metabolite, EDDP, were determined by UPLC-MS/MS...
June 22, 2017: Drug Testing and Analysis
https://www.readbyqxmd.com/read/28642082/clinical-trial-of-the-effects-of-vitamin-d-supplementation-on-psychological-symptoms-and-metabolic-profiles-in-maintenance-methadone-treatment-patients
#8
Amir Ghaderi, Hamid Reza Banafshe, Maryam Motmaen, Morad Rasouli-Azad, Fereshteh Bahmani, Zatollah Asemi
BACKGROUND: Vitamin D deficiency may be associated with some complications including nonspecific musculoskeletal pain and periodontal disease in maintenance methadone treatment (MMT) patients. This study was designed to determine the effect of vitamin D supplementation on psychological symptoms and metabolic profiles in MMT patients. METHODS: This randomized, double-blind, placebo-controlled, clinical trial was carried out among 68 MMT patients. Participants were randomly allocated to receive either 50,000IU vitamin D supplements (n=34) or placebo (n=34) every 2weeks for 12weeks...
June 19, 2017: Progress in Neuro-psychopharmacology & Biological Psychiatry
https://www.readbyqxmd.com/read/28641929/initiation-and-engagement-with-methadone-treatment-among-pregnant-and-postpartum-women
#9
Kristin M Mattocks, Robin Clark, Linda Weinreb
PURPOSE: The purpose of this study was to explore perceptions of experiences and challenges with methadone maintenance treatment (MMT) and obstetrical care among pregnant and postpartum women enrolled in a methadone maintenance program. RESEARCH DESIGN: The study featured a grounded theory approach including two focus groups with pregnant and postpartum methadone users at a methadone maintenance clinic in Worcester, Massachusetts. Two research team members conducted and recorded focus groups, which took approximately 45 minutes to 1 hour...
June 19, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28635521/assessment-of-an-innovative-voluntary-substance-abuse-treatment-program-designed-to-replace-compulsory-drug-detention-centers-in-malaysia
#10
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
#11
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/28631527/buprenorphine-naloxone-versus-methadone-and-lofexidine-in-community-stabilisation-and-detoxification-a-randomised-controlled-trial-of-low-dose-short-term-opiate-dependent-individuals
#12
Fergus D Law, Alison M Diaper, Jan K Melichar, Simon Coulton, David J Nutt, Judy S Myles
Buprenorphine/naloxone, methadone and lofexidine are medications with utility in the treatment of opiate withdrawal. We report the first randomised controlled trial to compare the effects of these two medications on withdrawal symptoms and outcome during opiate induction/stabilisation and detoxification. A double-blind randomised controlled trial was conducted in an outpatient satellite clinic of a specialist drug service. Eighty opiate dependent individuals meeting DSM-IV criteria for opiate dependence, using ⩽ ½ g heroin smoked/chased or ¼ g heroin injected or ⩽ 30mg methadone, with ⩽ 3 years of opioid dependency, underwent a short-term opiate treatment programme involving induction/stabilisation on methadone 30mg or buprenorphine/naloxone 4mg/1mg, followed by detoxification (where the methadone group was assisted by lofexidine)...
June 1, 2017: Journal of Psychopharmacology
https://www.readbyqxmd.com/read/28628897/diverted-medications-and-new-psychoactive-substances-a-chemical-network-analysis-of-discarded-injecting-paraphernalia-in-hungary
#13
Valéria Anna Gyarmathy, Anna Péterfi, Tamás Figeczki, József Kiss, Katalin Medgyesi-Frank, János Posta, József Csorba
BACKGROUND: Until about 2010, people who inject drugs (PWIDs) injected almost exclusively heroin and amphetamines in Hungary. After 2010, self-reported studies have indicated a dominance of new psychoactive substances on the drug market for injectable drugs. METHODS: Between March 2015 and February 2016, we collected used and discarded injecting paraphernalia. We utilized chemical analysis to assess and UCINet to visualize the connections between the most prevalent main substances and their respective co-occurring additional components at 7 locations in Hungary...
June 16, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28628854/prevalence-and-predictors-of-hcv-among-a-cohort-of-opioid-treatment-patients-in-dar-es-salaam-tanzania
#14
Barrot H Lambdin, Jennifer Lorvick, Jessie K Mbwambo, John Rwegasha, Saria Hassan, Paula Lum, Alex H Kral
BACKGROUND: The government of Tanzania launched an opioid treatment program (OTP), using methadone, in Dar es Salaam in February of 2011. Hepatitis C virus (HCV) is a leading cause of morbidity and mortality globally, especially among people who inject drugs (PWID). We conducted a cross-sectional study among PWID engaged in OTP in Dar es Salaam to describe the prevalence and predictors of HCV antibody serostatus. METHODS: Routine programmatic data on patients enrolled in Muhimbili National Hospital's OTP clinic from February 2011 to January 2013 were utilized...
June 16, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28627763/suspected-methadone-toxicity-from-hospital-to-autopsy-bed
#15
Jaber Gharehdaghi, Asieh Takalloo-Bakhtiari, Hossein Hassanian-Moghaddam, Nasim Zamani, Mohammad-Javad Hedayatshode
High mortality rates have been reported for methadone in both adults and children. We aimed to determine the pattern of toxicity, possible underlying diseases and treatment challenges in patients referred to our center with early diagnosis of methadone toxicity and who later died. Medical files of all methadone-poisoned patients who had been admitted to a referral center of toxicology between March 2011 and March 2016, died during the hospital stay and sent for autopsy to Legal Medicine Organization were retrospectively evaluated...
June 19, 2017: Basic & Clinical Pharmacology & Toxicology
https://www.readbyqxmd.com/read/28621658/zoning-out-methadone-and-rising-opioid-related-deaths-in-ontario-reforms-and-municipal-government-actions
#16
Carol Strike, Miroslav Miskovic
In this commentary, we argue that the use of amendments to bylaws by Ontario cities and municipalities to restrict where and how methadone maintenance treatment (MMT) clinics and pharmacies operate may run counter to efforts to prevent record high rates of opioid-related overdoses. As the province of Ontario seeks to reform the opioid treatment system, it is crucial to understand the structural (e.g., stigma) and treatment system organization factors that drive the actions of municipalities such as those described above...
June 16, 2017: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28617422/reduced-narcotic-and-sedative-utilization-in-a-nicu-after-implementation-of-pain-management-guidelines
#17
D Rana, B Bellflower, J Sahni, A J Kaplan, N T Owens, E L Arrindell, A J Talati, R Dhanireddy
OBJECTIVE: To assess the opioid and benzodiazepine usage in a level IV NICU after implementation of pain guidelines. STUDY DESIGN: Guidelines were developed for infants undergoing surgical procedures and infants on mechanical ventilation. Data collected for period 1 (July to December 2013) and period 2 (March to August 2014). RESULTS: Gestational age, birth weight and infants with hypoxic respiratory failure or requiring major procedures were comparable in two periods...
June 15, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28611509/hepatitis-c-in-injection-drug-users-it-is-time-to-treat
#18
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/28610451/cognitive-function-is-largely-intact-in-methadone-maintenance-treatment-patients
#19
Odelia Elkana, Miriam Adelson, Glen M Doniger, Anat Sason, Einat Peles
OBJECTIVES: To confirm our previous findings of less cognitive impairments (based on cognitive screening tools) among Methadone Maintenance Treatment (MMT) patients who achieved take-home dose (THD) privileges. METHODS: a random sample of 65 Israeli MMT patients were studied using computerized, age and education standardized, cognitive domains (attention, executive function, memory, motor skills), and non-computerized phonetic and semantic verbal fluency. Cognitive scores were within ±1 standard deviation (SD) of average for most domains, including non-verbal IQ, attention and motor skills...
June 14, 2017: World Journal of Biological Psychiatry
https://www.readbyqxmd.com/read/28609749/fatal-and-non-fatal-opioid-overdose-in-opioid-dependent-patients-treated-with-methadone-buprenorphine-or-implant-naltrexone
#20
Erin Kelty, Gary Hulse
BACKGROUND: Illicit opioid use is associated with high rates of fatal and non-fatal opioid overdose. This study aims to compare rates of fatal and serious but non-fatal opioid overdose in opioid dependent patients treated with methadone, buprenorphine or implant naltrexone, and to identify risk factors for fatal opioid overdose. METHODS: Opioid dependent patients treated with methadone (n=3515), buprenorphine (n=3250) or implant naltrexone (n=1461) in Western Australia for the first time between 2001 and 2010, were matched against state mortality and hospital data...
June 10, 2017: International Journal on Drug Policy
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