Methadone Clinics: Changes in the Characteristics and Levels of Comorbidity Among New Patients Into Methadone Maintenance Treatment Program in British Columbia During Its Expansion Period From 1998-2006.
Changes in the Characteristics and Levels of Comorbidity Among New Patients Into Methadone Maintenance Treatment Program in British Columbia During Its Expansion Period From 1998-2006.
Subst Use Misuse. 2013 Jun 10;
Sharif B, Nosyk B, Sun H, Marsh DC, Anis A
We described the changing characteristics and comorbidity levels of new patients into Methadone maintenance treatment (MMT) program in British Columbia, Canada, during its expansion period of 1998-2006. Analyses used administrative data. Generalized regression models were applied using Charlson Comorbidity Index (CCI) and Chronic Disease Score (CDS) as outcomes. 12,615 individuals initiated MMT during 1998-2006, while their odds of having moderate CCI (1 ? CCI ? 4) and mean CDS increased by 60% and 11%, respectively, after adjusting for confounders. MMT entrants were presented with progressively higher levels of comorbidity, independent of other characteristics. Future MMT policies should address higher levels of comorbidity among new patients.
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Engagement, Retention, and Abstinence for Three Types of Opioid Users in Florida.
Subst Use Misuse. 2013 Jun 10;
McCabe BE, Santisteban DA, Mena MP, Duchene DM, McLean C, Monroe M
Prescription opioid use has grown rapidly, but few studies examined whether users have similar treatment responses as heroin users. Participants were 1,648 opioid users in Florida Access to Recovery (2004-2007). Participants engaged in methadone or buprenorphine maintenance had better retention than those in nonmaintenance treatment. Heroin only users (HO) had better engagement in nonmaintenance treatments and had worse retention than prescription opioid only users (PO). In methadone maintenance, PO were more likely to report opioid abstinence during treatment than heroin and prescription opioid users (H&P). Future research should focus on understanding and improving the treatment experience of opioid use subgroups.
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A dose titration study into the effects of diazepam or midazolam on the propofol dose requirements for induction of general anaesthesia in client owned dogs, premedicated with methadone and acepromazine.
Vet Anaesth Analg. 2013 Jun 10;
Robinson R, Borer-Weir K
OBJECTIVE: To assess the effect of a benzodiazepine co-induction on propofol dose requirement for induction of anaesthesia in healthy dogs, to describe any differences between midazolam and diazepam and to determine an optimal benzodiazepine dose for co-induction. STUDY DESIGN: Prospective, randomised, blinded placebo controlled clinical trial. ANIMALS: Ninety client owned dogs (ASA I-III, median body mass 21.5kg (IQR 10-33)) presented for anaesthesia for a variety of procedures. METHODS: Dogs were randomised to receive saline 0.1 mL kg(-1) , midazolam or diazepam at 0.2, 0.3, 0.4 or 0.5 mg kg(-1) . All dogs received 0.01 mg kg(-1) acepromazine and 0.2 mg kg(-1) methadone intravenously (IV). Fifteen minutes later, sedation was assessed and scored prior to anaesthetic induction. Propofol, 1 mg kg(-1) , was administered IV, followed by the treatment drug. Further propofol was administered until endotracheal intubation was possible. Recorded data included patient signalment, sedation score, propofol dosage and any adverse reactions. RESULTS: Midazolam (all groups combined) significantly reduced propofol dose requirement compared to saline (p < 0.001) and diazepam (p = 0.008). Midazolam (0.4 mg kg(-1) ) significantly reduced propofol dose requirement (p = 0.014) compared to saline, however other doses failed to reach statistical significance. Diazepam did not significantly reduce propofol dose requirement compared to saline (p = 0.089). Dogs weighing <5 kg, regardless of treatment group, required a greater propofol dose than those weighing 5-40 kg (p = 0.002) and those >40 kg (p = 0.008). Dogs which were profoundly sedated required less propofol than those which were mildly sedated (p < 0.001) and adequately sedated (p = 0.003). CONCLUSIONS AND CLINICAL RELEVANCE: Midazolam (0.4 mg kg(-1) ) given IV after 1 mg kg(-1) of propofol significantly reduced the further propofol dose required for intubation compared to saline. At the investigated doses, diazepam did not have significant propofol dose sparing effects. HubMed – Methadone
End of Life Management of Patients Who Have Been Established on Oral Methadone for Pain Control.
J Palliat Med. 2013 Jun 8;
Porteous A, Robson P, Lee M
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