Methadone Dosing and Prescribed Medication Use in a Prospective Cohort of Opioid-Dependent Pregnant Women.

Filed under: Methadone Clinics

Addiction. 2012 Dec 7;
Cleary B, Reynolds K, Eogan M, O’Connell M, Fahey T, Gallagher P, Clarke T, White M, McDermott C, O’Sullivan A, Carmody D, Gleeson J, Murphy D

AIMS: This study aimed to i) describe methadone dosing before, during and after pregnancy, ii) to compare the incidence of neonatal abstinence syndrome (NAS) between those with dose decreases and those with steady or increasing doses and iii) to describe prescribed medication use among opioid-dependent pregnant women. DESIGN: Prospective cohort study SETTING: Two Irish tertiary care maternity hospitals PARTICIPANTS: 117 pregnant women on methadone maintenance treatment (MMT) recruited between July 2009 and July 2010 MEASUREMENTS: Electronic dispensing records from addiction clinics and the Primary Care Reimbursement Service were used to determine methadone doses and dispensed medications in the year preceding and the month following delivery. The Finnegan score was used to determine need for medical treatment of NAS. FINDINGS: Of the 117 participants, sufficient dosing data were available for 89 women treated with MMT throughout pregnancy; 36 (40.4%) had their dose decreased from a mean pre-pregnancy dose of 73.3mg (Standard Deviation 25.5) to a third trimester dose of 58.0mg (SD 26.0). The corresponding figures for those with increased doses (n=31, 34.8%) were 70.7mg (SD 25.3) and 89.7mg (SD 21.0), respectively. The incidence of medically-treated NAS did not differ between dosage groups. Antidepressants were dispensed for 29 women (25.7%) during pregnancy, with the rate decreasing from pre-pregnancy to postpartum. Benzodiazepines were prescribed for 43 women (38.0%). CONCLUSION: In the Irish health service, opioid-dependent women frequently have their methadone dose decreased during pregnancy but this does not appear to affect the incidence of the neonatal abstinence syndrome in their babies.
HubMed – Methadone

Methadone in the chronic pain patient with a substance use disorder.

Filed under: Methadone Clinics

J Pain Palliat Care Pharmacother. 2012 Dec; 26(4): 368-70
Reisfield GM, Friedman CK

ABSTRACT Methadone, used both to treat opioid addiction and to manage chronic pain, is commonly prescribed as an opioid of choice for patients with chronic pain and comorbid substance use disorders. This practice apparently derives from the belief that because methadone is widely used in opioid addiction treatment programs, it is an excellent choice for the management of chronic pain in individuals with substance use disorders. However, chronic pain and addiction treatment contexts are vastly different. In recent years, methadone-related morbidity and mortality have skyrocketed, driven largely by its use as an analgesic. Methadone is a uniquely complex opioid, responsible for a disproportionate percentage of opioid-related morbidity and mortality. Its use in high-risk patients should not be a reflexive choice. Rather, it should be employed only after careful consideration of relative risks and benefits.
HubMed – Methadone

Prevalence and correlates of sexual risk behaviors among drug users in western China: implications for HIV transmission.

Filed under: Methadone Clinics

AIDS Res Hum Retroviruses. 2012 Dec 4;
Huang J, Jiang J, Li JZ, Yang X, Deng W, Abdullah AS, Qin B, Upur H, Zhong C, Wang Q, Wang Q, Ruan Y, Zou Y, Ye L, Xie P, Wei F, Xu N, Wei B, Liang H

Objectives: To describe the prevalence and correlates of sexual risk behaviors among drug users in western China and the implications for HIV transmission in this population. Methods: A cross-sectional survey of male drug users was conducted in methadone maintenance therapy clinics and detoxification centers in three western provinces of China. Factors associated with HIV sexual risk behaviors were identified by multiple logistic regression analysis. Results: Of 1304 drug users surveyed, nearly 54% never used condoms during sexual intercourse with a spouse or cohabitant, and this behavior was associated with coming from Chongqing (OR=1.86), being aged 36 and older (OR=5.03), being married or cohabiting (OR=1.68), having first taken drugs at age 30 and above (OR=1.80), and having received AIDS advice or detection from authorities in the past year (OR=1.95). 26% had had sex with casual sexual partners in the past year, and this behavior was associated with being married or cohabiting (OR=0.30), first taking drugs at age 31 and above (OR=0.42), received AIDS advice or HIV detection from authorities in the past year (OR=0.70). About 34% never used a condom when having sex with casual sexual partners, and this behavior was associated with coming from Guangxi (OR=2.81) or Chongqing (OR=2.73). Almost 14% had had commercial sex in the past year, and this behavior was associated with coming from Guangxi (OR=6.26) or Chongqing (OR=5.44), and having exchanged needles or received clean needles from the Needle Exchange Centers in the past year (OR=2.76). Nearly 23% had never used condoms when having commercial sex, and this behavior was associated with having received free condoms from authorities in the past year (OR=0.26). Conclusions: Sexual risk behaviors among drug users in Guangxi, Chongqing, and Xinjiang are common. Additional intervention strategies are needed to control the spread of HIV in this population.
HubMed – Methadone

More Methadone Clinics Information…

Comments are closed.