Response to Wouldes and Woodward: Maternal Methadone Dose During Pregnancy and Infant Clinical Outcome.
Response to Wouldes and Woodward: Maternal methadone dose during pregnancy and infant clinical outcome.
Neurotoxicol Teratol. 2013 Feb 14;
O’Grady KE, Jones HE, Jansson LM, Kaltenbach K
Effect of thienorphine on the isolated uterine strips from pregnant rats.
Eur J Pharmacol. 2013 Feb 14;
Zhou P, Yan L, Yong Z, Yu G, Dong H, Yan H, Su R, Gong Z
Opioid dependence is a serious worldwide health problem. Buprenorphine was used as an alternative to methadone for the treatment of opioid dependence, especially for pregnant women. Thienorphine was a partial opioid agonist with long-lasting antinociceptive effect and high oral bioavailability compared with its analog buprenorphine. Till now, there was still no research about the effect of thienorphine on the isolated uterine muscles. This study examined the effects of thienorphine on the isolated rat oestrus and pregnant uterine strips. Area under the curve (AUC), amplitude and frequency were studied. Thienorphine induced a concentration-dependent decrease in the frequency and amplitude of the contraction on the isolated oestrus and pregnant uterine strips. Thienorphine exhibited less inhibition on the contractile amplitude of the isolated uterine strips from pregnant rats with the IC50 of 54.11±7.41??, compared with buprenorphine (IC50. 19.42±2.34??). In addition, thienorphine also exhibited less inhibition on the contractile frequency of the isolated uterine strips from pregnant rats, with the IC50 of 70.68±12.44??, compared with buprenorphine ( IC50, 19.20±3.87??). On the isolated uterine muscle from pregnant rats, the AUC was decreased by thienorphine but was less potent than buprenorphine, the IC(50) was 37.31±7.43?? for thienorphine and 13.52±2.03?? for buprenorphine. Thienorphine exhibited longer duration on the isolated rat pregnant uterine strips than buprenorphine. Thienorphine has less influence and longer duration on the isolated rat uterine muscles during pregnancy, which may be a newuseful candidate for the opioid dependent pregnant women.
HubMed – Methadone
Methadone dose at the time of release from prison significantly influences retention in treatment: Implications from a pilot study of HIV-infected prisoners transitioning to the community in Malaysia.
Drug Alcohol Depend. 2013 Feb 12;
Wickersham JA, Zahari MM, Azar MM, Kamarulzaman A, Altice FL
OBJECTIVE: To evaluate the impact of methadone dose on post-release retention in treatment among HIV-infected prisoners initiating methadone maintenance treatment (MMT) within prison. METHODS: Thirty HIV-infected prisoners meeting DSM-IV pre-incarceration criteria for opioid dependence were enrolled in a prison-based, pre-release MMT program in Klang Valley, Malaysia; 3 died before release from prison leaving 27 evaluable participants. Beginning 4 months before release, standardized methadone initiation and dose escalation procedures began with 5mg daily for the first week and 5mg/daily increases weekly until 80mg/day or craving was satisfied. Participants were followed for 12 months post-release at a MMT clinic within 25 kilometers of the prison. Kaplan-Meier survival analysis was used to evaluate the impact of methadone dose on post-release retention in treatment. FINDINGS: Methadone dose ?80mg/day at the time of release was significantly associated with retention in treatment. After 12 months of release, only 21.4% of participants on <80mg were retained at 12 months compared to 61.5% of those on ?80mg (Log Rank ?(2)=(1,26) 7.6, p<0.01). CONCLUSIONS: Higher doses of MMT at time of release are associated with greater retention on MMT after release to the community. Important attention should be given to monitoring and optimizing MMT doses to address cravings and side effects prior to community re-entry from prisons. HubMed – Methadone
Older methadone patients achieve greater durations of cocaine abstinence with contingency management than younger patients.
Am J Addict. 2013 Mar; 22(2): 119-26
Weiss L, Petry NM
Contingency management (CM) interventions are efficacious in treating cocaine abusing methadone patients, but few studies have examined the effect of age on treatment outcomes in this population. This study evaluated the impact of age on treatment outcomes in cocaine abusing methadone patients.Data were analyzed from 189 patients enrolled in one of three randomized studies that evaluated the efficacy of CM versus standard care (SC) treatment.Age was associated with some demographics and drug use characteristics including racial composition, education, and methadone dose. Primary drug abuse treatment outcomes did not vary across age groups, but CM had a greater benefit for engendering longer durations of abstinence in the middle/older and older age groups compared to the younger age groups. At the 6-month follow-up, submission of a cocaine positive urine sample was predicted by submission of a cocaine positive sample at intake, higher methadone doses, and assignment to SC rather than CM treatment.As substance abusers are living longer, examination of the efficacy of pharmacological and psychosocial treatments specifically within older age groups may lead to a better understanding of subpopulations for whom enhanced treatments such as CM are warranted. (Am J Addict 2013;22:119-126).
HubMed – Methadone
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