Methadone drug abuse

Hubbard RL, Marsden ME, Rachal JV, et al Drug Abuse Treatment A National Study of Effectiveness. Chapel Hill, University of North Carolina Press, 1989 Hunt DE, Lipton DS, Goldsmith DS, et al It takes yom heart the image of methadone maintenance in the addict world and its effect on recruitment into treatment. Int J Addict 20 1751-1771, 1985-1986... 

Seecof R, Tennant FS Subjective perceptions to the intravenous rush of heroin and cocaine in opioid addicts. Am J Drug Alcohol Abuse 12 79—87, 1987 Sees KL, Delucci KL, Masson C, et al Methadone maintenance vs. 180-day psycho-socially enriched detoxification for treatment of opioid dependence a randomized controlled trial. JAMA 283 1303-1310, 2000 Sells SB Treatment effectiveness, in Handbook on Drug Abuse. Edited by Dupont RE, Goldstein A, O Donnell J. Washington, DC, U.S. Government Printing Office, 1979, pp 105-118... 

A dramatically different pattern is found in surveys of drug abuse treatment facilities. Substance abuse treatment centers have reported that more than 20% of patients use benzodiazepines weekly or more frequently, with 30%— 90% of opioid abusers reporting illicit use (Iguchi et al. 1993 Stitzer et al 1981). Methadone clinics reported that high proportions ofurine samples are positive for benzodiazepines (Darke et al. 2003 Dinwiddle et al. 1996 Ross and Darke 2000 Seivewright 2001 Strain et al. 1991 Williams et al. 1996). The reasons for the high rates of benzodiazepine use in opioid addicts include self-medication of insomnia, anxiety, and withdrawal symptoms, as well as attempts to boost the euphoric effects of opioids. 

Covi L, Hess JM, Kreiter NA Haertzen CA (1995). Effects of combined fluoxetine and counselling in the outpatient treatment of cocaine abusers. American Journal of Drug Alcohol Abuse, 21, 327-44 Craig RJ, Olson R Shalton G (1990). Improvement in psychological functioning among drug abusers inpatient treatment compared to outpatient methadone maintenance. Journal of Substance Abuse Treatment, 1, 11-19... 

Because BZDs can cause excessive sedation and misuse, especially in drug-abusing HIV-infected patients, buspirone may be a useful alternative. Batki ( 496) reported on the use of this agent in 17 opiate abusers with AIDS or ARC who were also taking methadone. In the 14 patients who remained on the drug for at least 2 weeks, there was a reduction in several aberrant behaviors without any incidence of abuse. 

Patients (n = 37) already enrolled in studies at the NIDA Archway Clinic were invited to participate. The subject population included 21 males and 16 females 68% of the participants were African Americans and 32% were Caucasian. The average age of the participants was 41.9 years. The participants had extensive drug abuse histories that included current opioid dependence, chronic cocaine use, and frequent use of other illicit drugs. Most (n = 35) were maintained on methadone in doses that ranged from 70 to 100 mg/day two participants were maintained on buprenorphine (16 mg/day). 

In 1970, the Comprehensive Drug Abuse Prevention and Control Act was enacted into federal law. One purpose of the act was to clarify the ways in which medical personnel could legally dispense methadone to heroin addicts. In order to further clarify heroin treatment parameters, the Narcotic Addict Treatment Act of 1974 was passed, which set forth minimum standards for all... 

Methadone is often used for opioid replacement therapy in intravenous drug abusers. The incidence of HIV infection is significantly higher in this population than in the general public, and interactions with drugs used for the treatment of AIDS are therefore important. 

All the studies demonstrated clearly that opiates could be detected in extracts from both head and axillary or pubic samples of drug abusers (Table 1). Concentrations measured in the different kinds of hair are similar in magnitude whatever the opiate analyzed. With one exception (Balabanova and Wolf ), the highest concentrations were found in pubic hair, followed by scalp hair and axillary hair. This has been confirmed in oxu" laboratory by a compilation of results obtained recently in 16 fatal heroin overdoses (Table 2). Besides, we found a very significant correlation between head hair and axillary or pubic hair concentrations for any of the opiates tested. On the other hand, even in patients receiving daily methadone treatment (Balabanova and Wolf ), no correlation has been reported between blood and head or nonhead opiate concentrations. This is not surprising since blood concentration represents a measure at the present moment and hair concentration represents a chronic accumulation. 

In patients with reduced respiratory reserve, such as those with emphysema, severe obesity, cor pulmonale, and kyphoscoliosis, opioids must be used with caution. The relative benefits and harms of using opioids in patients taking monoamine oxidase inhibitors, those with a history of drug abuse, asthma, hepatic impairment, hypotension, raised intracranial pressure, or head injury, and during pregnancy or breast feeding, should be carefully considered. Dextropropoxyphene, pethidine, and methadone should be used with caution (SEDA-21, 85). 

Methadone diversion, abuse, and misuse deaths increasing at alarming rate Product No. 2007-Q0317-001. Johnstown, PA US Department of Justice, National Drug Intelligence Center 2007. 

Methadone (Dolophine) Similar to morphine but longer duration of action used in drug abuse programs... 

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