Sweating methadone

There are two main treatments for the opiate withdrawal syndrome. One is replacement therapy with methadone or other X agonists that have a longer half-life than heroin or morphine, and produce mild stimulation rather than euphoria. They also produce cross-tolerance to heroin, lessening heroin s effect if patients relapse. Withdrawal is also treated with the 0C2 agonist clonidine, which inhibits LC neurons, thus counteracting autonomic effects of opiate withdrawal — such as nausea, vomiting, cramps, sweating, tachycardia and hypertension — that are due in part to loss of opiate inhibition of LC neurons. 

Al-Adwani A Basu N (2004). Methadone and excessive sweating. Addiction, 99, 259 Alford DP, Compton P Samet JH (2006). Acute pain management for patients receiving maintenance methadone or buprenorphine therapy. Annals of Internal Medicine, 144, 127-134... 

Tolerance to the narcotic properties of methadone develops within 4—6 weeks, but tolerance to the autonomic effects (for example constipation and sweating) develops more slowly. 

That first time I tvas twenty-three. Before long I was addicted, although I ve always snorted dope, never shot it Opiates have caused me lots of trouble, but what they do for my head is worth it. Now I m thirty-four and am on methadone maintenance I don t think methadone IS the best opiate for mc it makes me sweat terribly and has some other effects on my body I don t like, but it s great to be able to get what 1 need legally, so that I can spend time on things other than scoring. I hope one day more people will realize that some of us have to have opiates just to feel normal... 

Tolerance to the effects of methadone develops with repeated doses, but more slowly than is true for morphine. Likewise, withdrawal develops more slowly and is generally less intense but more prolonged than morphine withdrawal. Withdrawal symptoms include weakness, anxiety, insomnia, abdominal discomfort, sweating, and hot and cold flashes. ... 

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. 

Therapeutic doses of morphine cause dilation of cutaneous blood vessels. The skin of the face, neck, and upper thorax frequently becomes flushed. These changes may be due in part to the release of histamine and may be responsible for the sweating and pruritus that occasionally follow the systemic administration of morphine. Histamine release probably accounts for the urticaria commonly seen at the site of injection, which is not mediated by opioid receptors and is not blocked by naloxone. It is seen with morphine and meperidine but not with oxymorphone, methadone, fentanyl, or sufentanil. 

Methadone is frequently used to treat heroin, codeine, hydrocodone, oxycodone, and morphine addictions. Methadone when used as prescribed, is safe and effective and does not cause euphoric sensations but does relieve physical withdrawal symptoms and reduces physiologic cravings. Methadone does have side effects which may be intolerable to some patients. They include constipation, water retention, drowsiness, skin rash, excessive sweating, and change in sex drive. Methadone has been used successfully in the treatment of opioid addiction for over 30 years. 

Use activity H. are used in pharmacological research, they may have significance in the development of alcoholism, and are considered to be metabolites of tryptamine. Plasma levels of barman in heroin-depen-dent and methadone-substituted patients are elevated by ca. 200%. H. have hallucinogenic and narcotic activities. Extracts of the above-mentioned plants are thus used by traditional healers in central Asia. South American Indians and mestizos use the macerated bark of B. caapi as a hallucinogenic drink (ayahuasca= liana of the soul, also Yaje, Caapi), the effects begin with nervousness, sweating, nausea, and then intoxication states (visions in brilliant colors), dream-like... 

Brunet B, Bames AJ, Scheidweiler KB, Mura P, Huestis MA (2008) Development and validation of a solid-phase extraction gas chromatography-mass spectrometry method for the simultaneous quantification of methadone, heroin, cocaine and metabolites in sweat. Anal Bioanal Chem 392 115-127... 

Concheiro M, Shakleya DM, Huestis MA (2011) Simultaneous analysis of buprenorphine, methadone, cocaine, opiates and nicotine metabolites in sweat by liquid chromatography tandem mass spectrometry. Anal Bioanal Chem 400(1 ) 69-78... 

In an open study in 21 opioid-tolerant patients with severe cancer pain who were switched to methadone, the switch was generally well tolerated only one patient required treatment withdrawal, because of respiratory depression [85 ]. Drowsiness was one of the most frequent adverse effects (in six patients) but it was of moderate intensity and responded to dosage reduction. Constipation was problematic in six. Other effects included nausea and vomiting (n = 2), sweating (n = 2), and confusion (n = 1). 

Detection of 1-a-acetylmethadol (LAAM) and methadone, opiate derivatives that are used to treat heroin addiction, were both detected with positive-ion CI-MS using a mixture of ammonia and methane as the reagent gases. Moody et al. [29] used LLE and derivatized the metabolites of LAAM with trifluoroacetic anhydride (TFAA) prior to quantitation with deuterated internal standards and calibration curves to determine limits of quantitation of 5 to 10 ng/ml. In contrast, Alburges et al. [30] carried out SPE of plasma, urine, and tissue samples, but did not derivatize the analytes because methadone and its metabolites have no easily derivatized functional groups. Quantitation with deuterated internal standards showed a linear dynamic range of 10 to 600 ng/ml when positive-ion Cl and SIM were used for detection. Detection of heroin and its metabolites in sweat has been reported by Kintz et al. [31]. They used BSTFA for derivatization of the metabolites of heroin extracted by LLE with use of a deuterated internal standard and calibration curves for quantitation. The LODs were 0.5 to 1 ng/ml using El and SIM for MS detection. 

---