BACKGROUND Opioid switching to methadone is reported frequently to improve pain control in patients with an unacceptable balance between pain control and side effects during treatment with first line opioids, but carries a risk of drug accumulation and respiratory depression. To justify this risk it is required that less risky treatments are tried beforehand and that a sufficiently large propor...

Morgan et al. report a number of important findings, but of greatest interest to providers of drug treatment services is probably that methadone-related deaths dramatically declined from 1997 onwards. Deaths per thousand methadone treatment patient-years varied little between 12 and 13/year between 1993 and 1997 but then plunged by three-quarters between 1997 and 2004 to a low of 3.1 deaths per...

Dr. Eamon Keenan The previous speaker has given a reasoned a balanced argument in favour of the use of methadone as an effective intervention in the treatment of opiate dependence syndrome. One interesting point to emerge and one that highlights the emotive nature of methadone treatment, is his justification of methadone maintenance on utilitarian moral grounds. That a medicinal product, with p...

ate brief wellbeing measures could facilitate discussions about broader life needs to be addressed. Further, insights from the literature on subjective wellbeing may inform services and interventions to help people establish happier, more meaningful lives within which addiction holds less attraction.’ The increasing acceptance and availability of agonist maintenance treatment is well documented...

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 ...

Previously, we have shown that SH-SY5Y cells exposed to high concentrations of methadone died due to a necrotic-like cell death mechanism related to delayed calcium deregulation (DCD). In this study, we show that, in terms of their Ca(2+) responses to 0.5 mM methadone, SH-SY5Y cells can be pooled into four different groups. In a broad pharmacological survey, the relevance of different Ca(2+)-re...

Effects of Methadone on Olfactory Memory Span Melissa Deal In 2008, an estimated 268,000 individuals received methadone in certified opioid treatment programs in the United States in an effort to effectively treat an opiate addiction (Substance Abuse and Mental Health Services Administration, 2010). Because of its high rate of use, a major concern regarding methadone maintenance is the possibil...

UNLABELLED Methadone is a synthetic opioid analgesic that is used as an alternate to morphine and hydromorphone for patients with severe pain. It is increasingly being used in opioid rotation schedules. Methadone has an asymmetric carbon atom resulting in 2 enantiomeric forms, the d and l isomers. The racemic mixture (dl-methadone) is the form commonly used clinically. Recent studies have revea...

The authors reviewed cases investigated by the Palm Beach Medical Examiner’s Office in which postmortem toxicologic studies indicated the presence of methadone over the period from 1998 to 2002, to examine the role of the drug in these deaths. There were 139 methadonepositive cases, including 75 in which the death was attributed to combined drug toxicity and 23 to methadone toxicity alone. Meth...