Although the efficacy of methadone maintenance treatment (MMT) in opioid dependence disorder has been well established, the influence of methadone pharmacokinetics in dose requirement and clinical outcome remains controversial. The aim of this study is to analyze methadone dosage in responder and nonresponder patients considering pharmacogenetic and pharmacokinetic factors that may contribute t...

Purpose: To review the literature on methadone deaths and propose evidencebased dosing guidelines. Methods: A literature search was conducted on overdose deaths during the induction phase. Data on methadone deaths from the Ontario coroner’s office, as well as prescribing guidelines from different countries and jurisdictions, were reviewed. The information was collectively considered and, using ...

BACKGROUND Opiate dependence is a major health and social issue in many countries. A mainstay of therapy has been methadone maintenance treatment, but other treatments, particularly buprenorphine, are increasingly being considered. AIM To conduct a systematic review to synthesise and critically appraise the evidence on the effectiveness of community maintenance programmes with methadone or bu...

OBJECTIVES This case report aims to help healthcare providers and methadone clinic patients to recognize one of the less recognized adverse effects of methadone, hyperhidrosis, and to suggest oxybutynin as a possible solution. METHODS A 35-year-old man on methadone maintenance therapy presented with excessive sweating, which began promptly after methadone was introduced. Urine toxicology was ...

Background: Use of opioids is associated with hypoactive sexual desire, erectile and orgasmic dysfunction. 16-30% of patients in methadone-maintained Therapy (MMT) may develop erectile dysfunction (ED). Objective: To evaluate the efficacy of Bupropion (an antidepressant which can improve sexual function) in treatment of Methadone induced sexual dysfunction. Method: Patients recruited from 3 Met...

OBJECTIVES To estimate the effects of methadone programs in New South Wales on mortality. DESIGN AND CASES: Retrospective, cross-sectional study of all 1994 New South Wales coronial cases in which methadone was detected in postmortem specimens taken from the deceased. Cases were people we identified as patients in NSW methadone maintenance programs or those whose deaths involved methadone syrup...

Introduction: Methadone has been an essential medication in the treatment of opioid addiction worldwide. Aim: To discuss dosing considerations related to different methadone programs. Method: A search was performed the Ovid (all resources) including: Medline, Cochrane, and EMBASE databases using the following terms: methadone dose, methadone optimization, and methadone adequacy. We compared and...

BACKGROUND Methadone maintenance treatment is the most widely prescribed treatment for opiate dependence with proven benefits for patients. In naïve users or in case of recreational misuse, methadone can be a source of potentially lethal intoxications, resulting in fatal overdoses. A few cases of infantile intoxications have been described in the literature, some of which resulted in death. Now...

Sir—Ritter et al .’s [1] claims their results show ‘LAAM maintenance has equivalent efficacy to methadone’ and ‘both treatments were equally effective in retaining clients in maintenance treatment’ are misleading. Their retention results actually favour methadone and their study was too small to identify confidently a clinically significant difference between the two maintenance drugs. The tria...

AIMS This paper reviews the published literature regarding outcomes following maternal treatment with buprenorphine in five areas: maternal efficacy, fetal effects, neonatal effects, effects on breast milk and longer-term developmental effects. METHODS Within each outcome area, findings are summarized first for the three randomized clinical trials and then for the 44 non-randomized studies (i...