Cannabis Methadone

Normal sexual activity is associated with ovulation in most female mammals. Compounds affecting this process can adversely affect female libido. Ovarian failure induced by xenobiotic compounds has been associated with a decrease in libido in women. Certain types of oral contraceptives as well as drugs of abuse (methadone, cannabis, alcohol) cause decreases in female libido. The treatment for hirsutism, excessive growth of hair in both normal and abnormal locations, is the compound cyproterone acetate. It is an antiandrogen that has the side effect of severely decreasing libido in women. 

The situation of daily dependent heroin use was sufficient to merit methadone treatment, but a (requested) detoxification attempt was not successful. His initial dosage was reinstated and the urine tests at his further appointments did not show heroin, but four consecutive tests showed cocaine, benzodiazepines and cannabis, in addition to his methadone. He was generally unenthusiastic about methadone, and after a pattern of missing an increasing number of collection days he dropped out of engagement with us. 

Ben Amar M Potvin S (2007). Cannabis and psychosis what is the link Journal of Psychoactive Drugs, 39, 131-142 Bennett GA, Davies E Thomas P (2003). Is oral fluid analysis as accurate as urinalysis in detecting drug use in a treatment setting Drug and Alcohol Dependence, 72, 265-9 Bertschy G (1995). Methadone maintenance treatment an update. European Archives of Psychiatry and Clinical Neuroscience, 245, 114-24... 

Steels MD, Hamilton M McLean PC (1992). The consequences of a change in formulation of methadone prescribed in a drug clinic. British Journal of Addiction, 87, 1549-54 Steinberg KL, Roffman RA, Carroll KM, Kabela E, Kadden R, Miller M Duresky D (2002). Tailoring cannabis dependence treatment for a diverse population. Addiction, 97, 135-42... 

The role of methadone and opiates in accidental overdose deaths in New York City has been investigated using data from the Office of Chief Medical Examiner of all accidental drug overdose deaths between 1990 and 1998 (51). There were 7451 overdose deaths in all during this period, of which 1024 were methadone-induced, 4627 were heroin-induced, and 408 were attributable to both. Thus, 70% of the deaths from accidental overdose were due to opiates. Co-variates significantly associated with methadone-induced deaths were female sex, older age, and absence of cocaine, heroin, cannabis, and alcohol in toxic screens. Co-variates associated with heroin overdose were male sex, Caucasian or Hispanic ethnicity, younger age, and the absence of cocaine and methadone and the presence of cannabis and alcohol in toxic screens. 

In 10 stable patients maintained on methadone (50-120 mg/day) and nine healthy subjects assessed using polysomnography, the methadone-maintained patients had more abnormalities of sleep architecture, with a higher prevalence of central sleep apnea (23). Methadone depresses respiration, probably by acting on p opioid receptors in the ventral surface of the medulla and possibly on other receptor sites in the lung and spinal cord. All the patients taking methadone also used benzodiazepines and cannabis, which may have influenced the above findings. 

CANNABIS ANALGESICS - OPIOIDS -alfentanil, fentanyl, methadone, codeine, dextromethorphan Unpredictable changes in plasma concentration. Risk of toxicity or therapeutic failure, particularly of drugs with a narrow therapeutic index Induction or inhibition of CYP3A4-mediated metabolism by cannabis. It is not yet known whether the effects are dependent on the degree of cannabis consumption Be aware. Watch for signs of toxicity, especially when cannabis use abruptly changes... 

Special arrangements apply to the prescribing of drugs of dependence in the UK under the provisions of the Misuse of Drugs Act 1971. Drugs controlled include cocaine, dipipanone, diamorphine (heroin), methadone, morphine, opium, pethidine, phencyclidine, lysergjde (LSD), amphetamines, barbiturates, cannabis, codeine, pholcodine, and certain drugs related to the amphetamines, such as chlorphentermine and diethylpropion. 

Nixon LN. Cannabis use and treatment outcome in methadone maintenance. A[Pg.169]

Drug-drug interactions Cannabis Cannabis is commonly used by individuals taking methadone maintenance treatment. In a study of the effects of cannabis on methadone pharmacokinetics in 151 patients taking methadone maintenance, cannabis use and higher methadone doses were associated with a lower trough methadone concentration, believed to reflect rapid methadone clearance [122 ]. 

Hallinan R, Crettol S, Agho K, Attia J, Besson J, Croquette-Krokar M, Hammig R, Deglon J-J, Byrne A, Ray J, Somogyi AA, Eap CB. Cannabis and benzodiazepines as determinants of methadone trough plasma concentration variability in maintenance treatment a transnational study. Eur J Qin Pharmacol 2009 65 1113-20. 

Cannabis The combination of cannabis with methadone has been studied in 77 Australian and 74 Swiss methadone maintenance patients [98 ]. There were lower 24-hour dose-corrected trough plasma concentrations of both (i )-methadone and (S)-methadone there was no effect of sex, alcohol, tobacco smoking, or duration of methadone treatment. 

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