Management of Chronic Neuropathic Pain of Different Causes With the Combination of Oral Methadone Along With Ketamine: A Report of 18 Cases.
Management of chronic neuropathic pain of different causes with the combination of oral methadone along with ketamine: A report of 18 cases.
Eur J Anaesthesiol. 2013 Apr 25;
Godoy MC, Dalmolin GD, Rigo FK, Rossato MF, Menezes MS, Alvarez MA, Hernandes JJ, Moreno LA, Sinche M, Ferreira J
Comparison of the transcriptional responses induced by acute morphine, methadone and buprenorphine.
Eur J Pharmacol. 2013 Apr 24;
Belkaï E, Crété D, Courtin C, Noble F, Marie-Claire C
Despite their widespread use in opioid maintenance treatment and pain management, little is known about the intracellular effectors of methadone and buprenorphine and the transcriptional responses they induce. We therefore studied the acute effects of these two opioids in rats, comparing our observations with those for the reference molecule, morphine. We determined the analgesic ED50 of the three molecules in the tail flick test, to ensure that transcriptional effects were compared between doses of equivalent analgesic effect. We analysed changes in gene expression over time in three cerebral structures involved in several opioid behaviours – the dorsal striatum, thalamus and nucleus accumbens – by real-time quantitative PCR. We analysed the expression of genes encoding proteins of the endogenous opioid system in parallel with that of Fos, a marker of neuronal activation. The acute transcriptional effects of methadone resembled those of morphine more closely than did those of buprenorphine, in terms of kinetics and intensities. Our results provide the first evidence that these two drugs widely used in pain management and opioid maintenance treatment can disturb the regulation of endogenous opioid system genes and induce molecular outcomes different from those observed with morphine.
HubMed – Methadone
The role of the Chinese police in methadone maintenance therapy: A literature review.
Int J Drug Policy. 2013 Apr 25;
Meng J, Burris S
BACKGROUND: The behavior of police is an important factor in drug users’ access to preventive and therapeutic health services. In China, opiate users must be registered and approved by police before accessing methadone maintenance treatment (MMT). METHODS: We conducted a literature review to identify studies reporting original data about the influence of Chinese drug policing activities on MMT access and outcomes. Searches were conducted in PubMed, the Law Journal Library of HeinOnline, the Social Science Citation Index and China Academic Journals of CNKI for empirical studies conducted in China and published in academic journals between 2005 and April 2012. RESULTS: The initial literature search retrieved 276 records, of which 85 were included in the review and 191 were excluded. The majority of the included papers were single-clinic observational studies. These studies reported that: (1) fear of incarceration deterred users from initiating and continuing MMT; (2) the rates of MMT referral by police were considerably lower than those by drug user peers and by community and the media; (3) police sending users to compulsory detoxification (DETOX) and reeducation through labor (RTL) centers contributed to higher rates of MMT patient dropout; (4) arrests in and around MMT clinics were not uncommon; (5) cooperation between local police and public health agencies was difficult to achieve; and (6) a limited number of trial programs were conducted to refer detainees in DETOX to MMT clinics after release, but the outcomes were not promising. CONCLUSION: Reviewed studies report drug policing practices that appear to be impeding MMT access and reducing successful treatment outcomes. Research focusing on the nature, prevalence and severity of these effects is urgently needed. Health and public security officials in China should review and reform policies and practices of registering, monitoring, and incarcerating drug users.
HubMed – Methadone
Concentrations of drugs determined in blood samples collected from suspected drugged drivers in England and Wales.
J Forensic Leg Med. 2013 May; 20(4): 278-89
Burch HJ, Clarke EJ, Hubbard AM, Scott-Ham M
This communication reports the blood concentrations of alcohol and drugs from 376 cases of alleged driving under the influence of drugs analysed at the Forensic Science Service Chorley and London laboratories between February 2010 and March 2011. The samples were analysed for alcohol, amphetamine, benzodiazepines, cocaine, MDMA, opiates, ?-hydroxybutyrate (GHB), ketamine, methadone and methylmethcathinone (the 4-isomer of which is known as mephedrone). The results were interpreted with respect to the number and type of drugs of abuse detected and the concentrations measured. Alcohol was quantified in 113 cases (30%), and of these a level in excess of the prescribed UK limit for driving of 80 mg% was present in 90 cases. In 80 cases, only the concentration of alcohol was measured, the concentrations of both drugs and alcohol were measured in 33 cases. In the remaining 263 cases, only the concentrations of relevant drugs of abuse were measured. The most common drug of abuse quantified was cocaine which was detected in 92 cases, either as the active drug or as its major metabolite benzoylecgonine, followed by diazepam which was quantified in 76 cases. Concentrations of some new drugs, and drugs rarely reported in driving under the influence cases are also presented.
HubMed – Methadone
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