Methadone drug administration

Methadone has Food and Drug Administration indications for the management of pain in adults and for adult narcotic addiction. Adverse events are those expected from opiate exposures gastrointestinal symptoms, CNS depression, and respiratory depression in larger doses, bradycardia, and constipation. Methadone appears to be fairly well tolerated by... 

Kao DP, Hmgney MC, Mehler PS, Krantz MJ (2015) Arrhythmia associated with buprenorphine and methadone reported to the Food and Drug Administration. Addiction 110 1468-1475... 

Initially, methadone was limited to detoxification treatment or maintenance treatment within US Food and Drug Administration-approved narcotic addiction programs. This restriction was removed in 1976 all physicians with appropriate Drug Enforcement Agency registration now are allowed to prescribe methadone for analgesia. 

FIG. 2. Comparison of the discriminative stimulus properties of LSD, morphine, and methadone when injected into the DRN of the rat. Rats were trained to discriminate LSD (120 ng/kg s.c.), cannulae implanted, and generalization from peripheral to central administration determined over a variety of doses of each drug. (Redrawn from the research of Rosecrans and Glennon, ref. 59.) A, I.C. saline, , I.C. morphine in morphine trained rats, O, I.C. saline, , I.C. LSD in LSD trained rats, , I.C. saline, , I.C. methadone in methadone trained rats. 

The treatment of opioid abuse and dependence aims also at preventing the social complications of abuse, especially infections linked to parenteral administration (HIV and HepB). It relies on the use of substimtive drugs that can be either pure agonists, or partial agonist-antagonists (methadone, buprenor-phine, naltrexone), with the objective of limiting receptor desensitization and the development of tolerance. Any success in the treatment of opiate dependence may stem as much from the re-establishment of healthcare contact and social reinsertion as from any treatment induced decrease in the abuse behaviour itself. 

L B. The most commonly used treatment and the most effective is to stabilize the patient with methadone and gradually reduce the maintenance dose until the patient is drug free. The administration of meperidine would reverse the abstinence syndrome but it is unlikely to help the patient terminate his opioid habit. The use of naltrexone would likely further precipitate the abstinence syndrome and without additional counseling, would not likely offer long-term beneht. 

There are not currently any medications that have been approved for treatment of MDMA addiction. In actuality, very few drugs of abuse have possible medical (pharmaceutical) treatments. Heroin addiction is one disease that is treatable by pharmaceutical means. Heroin addiction is often treated with methadone or levo-alpha-acetyl methadol (LAAM) administration. Similarly, alcohol addiction may be treated with pharmacological tools. However, most stimulants, such as cocaine, amphetamine, and MDMA, do not have medications available for treatment of addiction. 

Davis MP, Walsh D Methadone for relief of cancer pain A review of pharmacokinetics, pharmacodynamics, drug interactions and protocols of administration. Support Care Cancer 2001 9 73. [PMID 11305074]... 

Contraindications to interferon alfa therapy include hepatic decompensation, autoimmune disease, and history of cardiac arrhythmia. Caution is advised in the setting of psychiatric disease, epilepsy, thyroid disease, ischemic cardiac disease, severe renal insufficiency, and cytopenia. Alfa interferons are abortifacient in primates and should not be administered in pregnancy. Potential drug-drug interactions include increased theophylline levels and increased methadone levels. Co-administration with didanosine is not recommended because of a risk of hepatic failure, and co-administration with zidovudine may exacerbate cytopenias. 

After drugs are approved, the FDA tracks reports of errors due to drug name confusion and spreads the word to health professionals, along with recommendations for avoiding future problems. For example, the FDA has reported errors involving the inadvertent administration of methadone, a drug used to treat opiate dependence, rather than the intended Metadate ER (methylphenidate) for the treatment of attention-deficit/hyperactivity... 

Moreton, J. Edward, Timothy Roehrs, and Naim Khazan. 1976. "Drug Self-Administration and Sleep-Wake Activity in Rats Dependent on Morphine, Methadone, or L-Alpha-Acetylmethadol." Psychopharmacologia 47 237-41. 

Young, Gerald A., George F. Steinfels, and Naim Khazan. 1978. Transitional Patterns of Self-Administration Following Substitution of Methadone or L-Alpha-Acetylmethadol (LAAM) for Morphine in Dependent Rats." Drug and Alcohol Dependence 3 273-79. 

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