Corrected QT interval during treatment with methadone and buprenorphine-Relation to doses and serum concentrations.

Filed under: Methadone Detox

Drug Alcohol Depend. 2012 Oct 16;
Stallvik M, Nordstrand B, Kristensen O, Bathen J, Skogvoll E, Spigset O

BACKGROUND: Methadone and buprenorphine are widely used in the treatment of opioid addiction. Some study results suggest that methadone can be associated with QT interval prolongation and torsades de pointes ventricular arrhythmias, whereas no such risk has been observed for buprenorphine. The aim of this study is to determine the risk of corrected QT interval (QTc) increase among patients treated with these medications in an opioid maintenance treatment (OMT) programme, and to study possible associations between QTc changes and serum concentrations of methadone or buprenorphine. METHODS: Eighty patients enrolled in the OMT programme were followed after start of treatment with methadone (n=45) or buprenorphine (n=35). QTc interval was assessed by electrocardiography (ECG) at baseline and after 1 month (n=79) and 6 months (n=66) in the OMT programme. Blood samples were obtained for the analysis of serum concentrations of buprenorphine, (R)-methadone, (S)-methadone and total methadone. RESULTS: No patients had QTc prolongation (defined as a QTc value above 450ms) at baseline or after 1 or 6 months. When analysed in a linear mixed effects model, QTc was not associated with the serum concentrations of buprenorphine or methadone. However, low serum potassium levels increased QTc significantly. CONCLUSIONS: These results support and extend previous findings that treatment with methadone in modest doses (i.e. below 100mg/d) is not associated with clinically significant QTc increases, and that buprenorphine in commonly used doses is a suitable alternative to methadone with regard to the risk of QTc prolongation.
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Posttraumatic stress disorder and one-year outcome in methadone maintenance treatment.

Filed under: Methadone Detox

Am J Addict. 2012 Nov; 21(6): 524-30
Himelhoch S, Weber E, Medoff D, Charlotte M, Clayton S, Wilson C, Ware R, Benford J

Background: Although opiate use may be associated with posttraumatic stress disorder (PTSD), it is not clear whether PTSD is associated with retention in methadone maintenance. Objectives: To evaluate among those receiving methadone maintenance at an urban methadone maintenance clinic the frequency of life-time traumatic experiences, the predictors and prevalence of current PTSD, and whether PTSD affects retention at 1 year. Methods: Eighty-nine people participated in the study. The Post Traumatic Diagnostic Scale was used to determine the prevalence of PTSD. The Life Stressor Checklist Revised was used to evaluate trauma history. Logistic regression analyses examined associations between demographic characteristics, substance use, trauma-related variables, and PTSD. Similar logistic regression analyses were used to examine retention in methadone maintenance at 1 year. Results: The mean number of reported lifetime stressful events was 8.0 (SD = 3.7). Twenty-seven percent were diagnosed with PTSD. Nearly 92% of those with PTSD had co-occurring depressive symptoms. Female gender (adjusted odds ratio [AOR][95% CI]; 3.89 [1.07-14.01]), number of traumatic events (AOR [95% CI]; 1.34 [1.13-1.61]), and less education (AOR [95% CI]; 4.13 [1.14-14.98]) were significantly associated with PTSD. Those with a toxicology positive screen were 80% less likely to remaine in methadone maintenance at 1 year (OR [95% CI]; 0.20 [0.07-0.52]). PTSD diagnosis was not significantly associated with treatment retention at 1 year (OR [95% CI]; 0.61 [0.23-1.64]). Conclusions and Scientific Significance: Future studies are needed to determine if treatment of PTSD that is integrated into methadone maintenance programs may impact continued substance abuse use and thereby improve retention in care. (Am J Addict 2012;21:524-530).
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Formerly Addicted Mom Turns Life Around to Help Son

Filed under: Methadone Detox

Hazen was two months pregnant with Robert when she entered a methadone program in Anchorage. “We have people who've been on the waiting list for a year, year and a half, and … “It's definitely worrisome that babies are born addicted to drugs because …
Read more on KTVA CBS 11 News Alaska

Drug Use Spikes In 'Transit Countries'

Filed under: Methadone Detox

Russia's punitive approach to rehabilitation precludes the methods of medically controlled detox and harm-reduction that are almost universally accepted today. Even NGO-sponsored syringe distribution programs have been quashed by the Kremlin, and …
Read more on Hetq Online

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