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Use of Methadone in Opioid Maintenance Treatment

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Handbook of Methadone Prescribing and Buprenorphine Therapy

Abstract

Many studies have repeatedly shown that the daily administration of methadone decreases morbidity and mortality in patients with an addiction to opioids and related substances. First established in the 1960s, methadone programs soon become an essential component for the treatment of this patient population. In addition to the dispensing of methadone, the program provides medical and counseling services that are active components of the treatment plan. The legal aspects that regulate the MMT programs and the unique pharmacokinetics and pharmacodynamics of methadone require special attention.

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References

  1. Effective medical treatment of opiate addiction. NIH Consensus Statement Online 17–19 Nov 1997 [cited 17 March 2012].

    Google Scholar 

  2. Dole VP, Nyswander ME. Methadone maintenance: a ten year perspective. JAMA. 1976;193:646–50.

    Article  Google Scholar 

  3. Ball JC, Ross A. The effectiveness of methadone maintenance treatment: patients, programs, services, and outcomes. New York: Springer; 1991.

    Book  Google Scholar 

  4. D’Aunno T, Pollack H. Changes in methadone treatment practices. JAMA. 2002;288(7):850–6.

    Article  PubMed  Google Scholar 

  5. Blaney T, Craig R. Methadone maintenance: does dose determine differences in outcomes. J Subst Abuse Treat. 1999;16(3):221–8.

    Article  PubMed  CAS  Google Scholar 

  6. Substance Abuse and Mental Health Services Administration, Office of Applied Studies. National survey of substance abuse treatment services (N-SSATS); 2007.

    Google Scholar 

  7. Maremmani I, Barra M, Bignamini E, et al. Clinical foundations for the use of methadone. Italian consensus panel on methadone treatment. Heroin Addict Relat Clin Probl. 2002;4(2):19–32.

    Google Scholar 

  8. Maremmani I, Pacini M, Lubrano S, Lovrecic M. When “enough” is still not “enough”: effectiveness of high-dose methadone in the treatment of heroin addiction. Heroin Addict Relat Clin Probl. 2003;5(1):17–32.

    Google Scholar 

  9. Schoenbaum E, Hartel D, Selwyn P. Risk factors for human immunodeficiency virus infection in intravenous drug users. N Engl J Med. 1989;321:874–9.

    Article  PubMed  CAS  Google Scholar 

  10. Ward J, Hall W, Mattick R. Role of maintenance treatment in opioid dependence. Lancet. 1999;353:221–6.

    Article  PubMed  CAS  Google Scholar 

  11. Metzger D, Woody G, McLellan T, et al. Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18-month prospective follow-up. J Acquir Immune Defic Syndr. 1993;6:1049–56.

    PubMed  CAS  Google Scholar 

  12. Institute of Medicine. No time to lose: making the most of HIV prevention. Washington, DC: National Academy Press; 2000.

    Google Scholar 

  13. Hagan H, Des Jarlais DC. HIV and HCV infection among injecting drug users. Mt Sinai J Med. 2000;67:423–8.

    PubMed  CAS  Google Scholar 

  14. Pollack HA. Cost-effectiveness of harm reduction in preventing hepatitis C among injection drug users. Med Decis Making. 2001;21:357–67.

    PubMed  CAS  Google Scholar 

  15. Gronbladh L, Ohland M, Gunne L. Mortality in heroin addiction: impact of methadone treatment. Acta Psychiatr Scand. 1990;82:874–9.

    Article  Google Scholar 

  16. Marsch L. The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behaviour and criminality: a meta-analysis. Addiction. 1998;93:515–32.

    Article  PubMed  CAS  Google Scholar 

  17. American Psychiatric Association. Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author; 2000.

    Google Scholar 

  18. Wesson DR, Ling W. The Clinical Opiate Withdrawal Scale. J Psychoactive Drugs. 2003;35(2):253–9.

    Article  PubMed  Google Scholar 

  19. Code of Federal Regulations 42 CFR chapter 1, part 8.12 (i) (2) (i)–(viii).

  20. Benet L, Kroetz D, Sheiner L. Pharmokinetics. In: Hardman J, Limbird L, editors. The pharmacological basis of therapeutics. 9th ed. New York: McGraw-Hill; 1996. p. 3–27.

    Google Scholar 

  21. Stine SM, Greenwald MK, Kosten TR. Pharmacologic therapies for opioid addiction. In: Graham AW et al., editors. Principles of addiction medicine. 3rd ed. Chevy Chase, MD: American Society of Addiction Medicine; 2003. p. 735–50.

    Google Scholar 

  22. Strang J, McCmbridge J, Best D, et al. Loss of tolerance and overdose mortality after inpatient opiate detoxification: follow up study. BMJ. 2003;326:959–60.

    Article  PubMed  Google Scholar 

  23. California Society of Addiction Medicine (CSAM). Guidelines for physicians working in California Opioid Treatment Programs; 2009.

    Google Scholar 

  24. Craig RJ. Effectiveness of low dose methadone maintenance treatment for the treatment of inner city heroin addicts. Int J Addict. 1980;15:701–10.

    PubMed  CAS  Google Scholar 

  25. Gossop M, Marsden J, Stewart D, Treacy S. Outcomes after methadone maintenance and methadone reduction treatments: two-year follow up results from the National Treatment Outcomes Research Study. Drug Alcohol Depend. 2001;62:255–64.

    Article  PubMed  CAS  Google Scholar 

  26. Tenore PL. Guidance on optimal methadone dosing. Addict Treat Forum. 2003;12(3):1, 6–7.

    Google Scholar 

  27. Loimer N, Schmid R. The use of plasma levels to optimise methadone maintenance treatment. Drug Alcohol Depend. 1992;30(3):241–6.

    Article  PubMed  CAS  Google Scholar 

  28. Mitchell TB, Dyer KR, Newcombe D, Salter A, Somogyi AA, Bochner F, et al. Subjective and physiological responses among racemic–methadone maintenance patients in relation to relative (S)- vs. (R)-methadone exposure. Br J Clin Pharmacol. 2004;58:609–17.

    Article  PubMed  CAS  Google Scholar 

  29. Kreek MJ. Medical safety and side effects of methadone in tolerant individuals. JAMA. 1973;223:665–8.

    Article  PubMed  CAS  Google Scholar 

  30. Novick DM, Richman BL, Friedman JM, et al. The medical status of methadone maintained patients in treatment for 11–18 years. Drug Alcohol Depend. 1993;33:235–45.

    Article  PubMed  CAS  Google Scholar 

  31. Leavitt S. Methadone-drug interactions. Addict Treat Forum. Nov 2005.

    Google Scholar 

  32. Herrlin K, Segerdahl M, Gustafsson LL, Kalso E. Methadone, ciprofloxacin, and adverse drug reactions. Lancet. 2000;356(9247):2069–70.

    Article  PubMed  CAS  Google Scholar 

  33. Faragon JJ, Piliero P. Drug interactions associated with HAART: focus on treatments for addiction and recreational drugs. AIDS Read. 2003;13(9):433–50.

    PubMed  Google Scholar 

  34. Byrne A. Concerns about consensus guidelines for QTc interval screening in methadone treatment. Ann Intern Med. 2009;151(3):216.

    Article  PubMed  Google Scholar 

  35. Cohen SP, Mao J. Concerns about consensus guidelines for QTc interval screening in methadone treatment. Ann Intern Med. 2009;151(3):216.

    Article  PubMed  Google Scholar 

  36. Girgis G. Concerns about consensus guidelines for QTc interval screening in methadone treatment. Ann Intern Med. 2009;151(3):216.

    Article  Google Scholar 

  37. Bart G. Concerns about consensus guidelines for QTc interval screening in methadone treatment. Ann Intern Med. 2009;151(3):216.

    Article  Google Scholar 

  38. Gourevitch M. First, do no harm… reduction? Ann Intern Med. 2009;150:417–8.

    Article  PubMed  Google Scholar 

  39. Carpentier PJ, Krabbe PF, van Gagh MT, Knapen LJ, Buitelaar JK, de Jong CA. Psychiatric comorbidity reduces quality of life in chronic methadone maintained patients. Am J Addict. 2009;18(6):470–80.

    Article  PubMed  Google Scholar 

  40. Dyer RK, White JM, Foster DJR, Bochner F, Menenlaou A, Somogyi A. The relationship between mood state and plasma methadone concentration in maintenance patients. J Clin Psychopharmacol. 2001;21(1):78–84.

    Article  PubMed  CAS  Google Scholar 

  41. Barry DT, Beitel M, Garnet B, Joshi D, Rosenblum A, Schottenfeld RS. Relations among psychopathology, substance use, and physical pain experiences in methadone-maintained patients. J Clin Psychiatry. 2009;70:1213–8.

    Article  PubMed  Google Scholar 

  42. Jamison RN, Kauffman J, Katz NP. Characteristics of methadone maintenance patients with chronic pain. J Pain Symptom Manage. 2000;19:53–62.

    Article  PubMed  CAS  Google Scholar 

  43. Peles E, Schreiber S, Gordon J, Adelson M. Significantly higher methadone dose for methadone maintenance treatment (MMT) patients with chronic pain. Pain. 2005;113:340–6.

    Article  PubMed  CAS  Google Scholar 

  44. Rosenblum A, Joseph H, Fong C, Kipnis S, Cleland C, Portenoy RK. Prevalence and characteristics of chronic pain among chemically dependent patients in methadone maintenance and residential treatment facilities. JAMA. 2003;289:2370–8.

    Article  PubMed  Google Scholar 

  45. Winklbaur B, Kopf N, Ebner N, Jung E, Thau K, Fischer G. Treating pregnant women dependent on opioids is not the same as pregnancy and opioid dependence: a knowledge synthesis for better treatment for women and neonates. Addiction. 2008;103:1429–40.

    Article  PubMed  Google Scholar 

  46. Finnegan LP. Women, pregnancy and methadone. Heroin Addict Relat Clin Probl. 2000;2(1):1–8.

    Google Scholar 

  47. Suffett F, Brotman R. A comprehensive care programme for pregnant addicts: obstetrical, neonatal and child development outcomes. Int J Addict. 1984;19:199–219.

    Google Scholar 

  48. Sees K, Delucchi K, Masson C, et al. Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence. JAMA. 2000;283:1303–10.

    Article  PubMed  CAS  Google Scholar 

  49. Bell J, Zador D. A risk-benefit analysis of methadone maintenance treatment. Drug Saf. 2000;22(3):179–90.

    Article  PubMed  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Medicine, Beth Israel Medical Center MMTP, 160 Water Street, 24th Floor, New York, NY, 10038, USA

    Randy M. Seewald MBBS

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  1. Randy M. Seewald MBBS
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Correspondence to Randy M. Seewald MBBS .

Editor information

Editors and Affiliations

  1. , Dept of Pain Med and Palliative Care, Beth Israel Medical Center, Union Square East 10, New York, 10003, New York, USA

    Ricardo A. Cruciani

  2. , Dept of Pain Mgmt and Palliative Care, Beth Israel Medical Center, East 17th Street 350, New York, 10003, New York, USA

    Helena Knotkova

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Seewald, R.M. (2013). Use of Methadone in Opioid Maintenance Treatment. In: Cruciani, R., Knotkova, H. (eds) Handbook of Methadone Prescribing and Buprenorphine Therapy. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-6974-2_2

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  • DOI: https://doi.org/10.1007/978-1-4614-6974-2_2

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  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-6973-5

  • Online ISBN: 978-1-4614-6974-2

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