Methadone long-term effects

Roozen HG, Kerhof AJ, van den Brink W Experiences with an outpatient relapse program (community reinforcement approach) combined with naltrexone in the treatment of opioid-dependence effect on addictive behaviors and the predictive value of psychiatric comorbidity. Eur Addict Res 9 53—58, 2003 Rosen TS, Johnson HL Long-term effects of prenatal methadone maintenance. NIDA Res Monogr 59 73-83, 1985... 

The patient who uses methadone long-term may develop a tolerance to the drug s analgesic effect and physical dependence. 

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. 

Eklund C, Melin L, Hiltunen A Borg S (1994). Detoxification from methadone maintenance treatment in Sweden long-term outcome and effects on quality of life and life situation. The International Journal of the Addictions, 29, 627-45... 

Quang-Cantagrel ND, Wallace MS, Ashar N Mathews C (2001). Long-term methadone treatment effect on CD4+ lymphocyte counts and HIV-1 plasma RNA level in patients with HIV infection. European Journal of Pain, 5, 415-20... 

Opiate withdrawal symptoms can be reversed without inducing a euphoria of its own (like methadone). The tie-in may be related to findings that, at least in rats, long-term administration of morphine increases the brain s a-adrenoceptor population. If opiate withdrawal symptoms can be somehow related to a portion of the excess receptors being unoccupied, then clonidine s activation of them may, in part, explain its effectiveness. 

Side effects, toxicity, and conditions that alter sensitivity, as well as the treatment of acute intoxication, are similar to those described for morphine. During long-term administration, there may be excessive sweating, lymphocytosis, and increased concentrations of prolactin, albumin, and globulins in the plasma. Rifampin and phenytoin accelerate the metabolism of methadone and can precipitate withdrawal symptoms. 

There is evidence that long-term fusidic acid may modestly reduce the effects of methadone. 

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