Diversion of Benzodiazepines Through Healthcare Sources.
Diversion of benzodiazepines through healthcare sources.
J Psychoactive Drugs. 2013 Jan-Mar; 45(1): 48-56
Ibañez GE, Levi-Minzi MA, Rigg KK, Mooss AD
Benzodiazepines (BZ) are often diverted from legal sources to illicit markets at various points in the distribution process beginning with a pharmaceutical manufacturer, followed by healthcare providers, and finally, to the intended users. Little is known about the extent of BZ diversion involving distribution points directly related to healthcare sources versus points further down the distribution chain. The present study examines the scope of BZ diversion, and the association between BZ dependence and the direct utilization of particular healthcare-related diversion sources among a diverse sample of prescription drug abusers in South Florida. Cross-sectional data were collected from five different groups of drug users: methadone-maintenance clients (n = 247), street drug users (n = 238), public-pay treatment clients (n = 245), private-pay treatment clients (n = 228), and stimulant-using men who have sex with men (MSM; n = 249). Findings suggest that those who are ages 26 to 35 years old, non-Hispanic White participants, private-pay treatment clients, those who are insured, and those with higher incomes had higher odds of utilizing healthcare diversion sources. Those who reported BZ dependence had 2.5 times greater odds of using a healthcare source to obtain BZs than those who did not meet criteria for dependence.
HubMed – Methadone
Continuing methadone for pain in palliative care.
Pain Res Manag. 2013 Mar-Apr; 18(2): 83-6
Hawley P, Liebscher R, Wilford J
Methadone is one of the most important medications used for the treatment of refractory pain in the palliative care setting, and is usually initially prescribed by one of a limited number of physicians who have acquired authorization for its use. A lack of authorized physicians able to take over prescribing when the patient is stable is a barrier to accessing methadone for analgesia. To determine the barriers to family physicians becoming authorized to prescribe methadone for pain in palliative care. A survey exploring the perceived barriers to continuing methadone for pain in palliative care following initial prescription by a specialist was mailed to a randomly selected group of 870 family physicians in British Columbia. The response rate was 30.9%. Of the 204 responding physicians, 76.1% described themselves as positioned to provide ongoing palliative care to their patients. Within this group, 38 (18.6%) were already authorized to prescribe methadone for pain. The remaining 166 (81.4%) had significant knowledge deficits regarding methadone use in palliative care, but were largely aware of their deficits, and more than one-half were willing to learn more and to obtain an authorization if requested. Responding family physicians had mostly received little education regarding methadone for pain, but were aware of their need for education and were willing to learn. Physicians who had already become authorized were generally satisfied with the process of authorization, and believed the process of education through authorization was appropriate and not onerous.
HubMed – Methadone
A comparative study of beneficial effects of Olanzapine and sodium valproate on aggressive behavior of patients who are on methadone maintenance therapy: a randomized triple blind clinical trial.
Eur Rev Med Pharmacol Sci. 2013 Apr; 17(8): 1073-81
Zarghami M, Sheikhmoonesi F, Ala S, Yazdani J, Farnia S
Previous studies have shown a high prevalence of aggressive behavior in abstinent heroin users who are on methadone maintenance therapy (MMT) compared with healthy controls. Some studies suggest that olanzapine and valproate may be effective in managing aggressive behavior and preventing a relapse of substance misuse in patients on methadone regime.The aim of the present study was to evaluate and compare the effectiveness of these medications in the management of aggressive behavior and prevention of relapse in patients maintained on methadone.Two hundred and one patients on MMT were randomized into two treatment groups of olanzapine (2.5-15 mg) and sodium valproate (600-1000 mg). Both groups were treated for 12 weeks. Patients visited the clinic twice weekly to receive medication. Patients’ urine samples were screened for trace of any illicit substances on each visit. Upon each consultation, the clinicians, using overt aggression scale-modified version (OAS-M), assessed the degree and frequency of aggressiveness in each patient.Fifty three patients completed the trial. Both medications significantly reduced the overt aggression and subscales of irritability, aggression and suicidality. Improvement was more pronounced in the group treated with olanzapine. The mean percentages of positive urine samples for morphine, cannabis and methamphetamine abuse for the 12 weeks period of the study were not significantly different between the two groups.Both olanzapine and sodium valproate are useful as an adjunctive agent in reducing aggressive behavior in heroin dependent individuals who are on MMT, but the beneficial effect of olanzapine was greater than sodium valproate in this respect.
HubMed – Methadone
Report details hours before teen’s OD – Tyler Warner overdosed on Xanax and methadone in November 2011.
More Methadone Clinics Information…