Methadone Toxicity and Possible Induction and Enhanced Elimination in a Premature Neonate.

Filed under: Methadone Detox

J Med Toxicol. 2012 Aug 17;
George M, Kitzmiller JP, Ewald MB, O’Donell KA, Becter ML, Salhanick S

INTRODUCTION: Reports describing methadone overdose in adult and pediatric patient populations are not uncommon. Reports in the preterm neonate patient population, however, are infrequent even though the utilization of methadone in that population continues to increase. Significant age-related pharmacokinetic differences complicate the management of methadone overdose in neonates, and literature involving methadone toxicokinetics and toxicodynamics in pediatric and neonate populations is largely limited. CASE REPORT: The clinical course and pharmacologic data of a massive methadone overdose in a 20-day-old male neonate is described, and a contemporary review of developmental pharmacology is presented. DISCUSSION: As clinicians continue to use methadone in neonates, they should be aware of the many significant peculiarities regarding its toxicology and pharmacology in that patient population.
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How and why AIDS changed drug policy in Switzerland.

Filed under: Methadone Detox

J Public Health Policy. 2012 Aug; 33(3): 317-24
Somaini B, Grob P

Switzerland implemented a harm reduction program and reduced the spread of HIV within the drug scene, and from drug users into other population groups, earlier than many countries. Each canton developed strategies based on its drug problem. By 1985 it was obvious that ‘needle sharing’ was the most significant pathway in the transmission of HIV. Some cities established Drug Consumption Rooms and small-scale syringe exchange programs. However, a dramatic concentration of drug use in the Platzspitz (a park) of Zürich evolved where 1000-2000 drug users gathered daily, many of whom were infected with HIV. The Federal Office of Public Health financed needle exchange and other harm reduction programs, with evaluation. Within a few years the Swiss established low-threshold methadone treatment programs and Heroin-Assisted Therapy. In 2008, the Swiss approved a law based on the principles of a ‘four pillar system’: repression, prevention, harm reduction, and treatment.
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Comparison of Random and Postaccident Urine Drug Tests in Southern Indiana Coal Miners.

Filed under: Methadone Detox

J Addict Med. 2012 Aug 14;
Price JW

BACKGROUND:: This study examines the relationship between the use of 9 classes of substances (amphetamines, barbiturates, benzodiazepines, cocaine, marijuana, methadone, opioids, phencyclidine, and propoxyphene) and coal-mining accidents. METHODS:: The control sample (n = 215) made up of miners that presented for random urine drug testing. The study sample (n = 100) consists of miners that presented for postaccident urine drug testing. Nonparametric Mann-Whitney U tests of creatinine normalized urine drug levels were conducted to compare the medians of the groups. RESULTS:: The mean drug concentrations were higher in the postaccident group for each drug tested except marijuana. Two-tailed testing demonstrated statistically significant differences for marijuana (P = 0.000), cocaine (P = 0.008), and opiates (P = 0.037). CONCLUSIONS:: The study demonstrates statistically significant higher cocaine and opioid concentrations and lower marijuana concentrations in postaccident urine drug tests of coal miners when compared with random tests.
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Association Between Cholesterol Plasma Levels and Craving Among Heroin Users.

Filed under: Methadone Detox

J Addict Med. 2012 Aug 14;
Lin SH, Yang YK, Lee SY, Hsieh PC, Chen PS, Lu RB, Chen KC

OBJECTIVE:: Lipids may play some roles in the central nervous system functions that are associated with drug addiction. To date, cholesterol is known to influence relapse of cocaine use. However, the relationship between cholesterol and heroin craving is unclear. This study examined the concurrent association between cholesterol and craving. METHOD:: The serum lipid levels of 70 heroin users who were undergoing or had undergone a methadone maintenance therapy were measured. Their craving and demographic data were assessed. RESULTS:: Total cholesterol and low-density lipoprotein cholesterol are negatively associated with craving before (r = -0.33, P < 0.01, and r = -0.36, P < 0.01, respectively) and after controlling for the effects of potential confounders (? = -0.38, P < 0.01, and ? = -0.42, P < 0.01, respectively). CONCLUSIONS:: Cholesterol could be associated with the cognitive aspect of craving and may be a potential marker to predict risk of drug relapse. Source

How Can We Break Our Drug Habit?

Filed under: Methadone Detox

Suboxone and methadone are drugs used both for detoxification of heroin addicts, allowing them to stop using heroin, and in long-term maintenance programs in which addicts use them instead of heroin. Both can be abused, and both can lead to death by …
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