The effect of P-Glycoprotein on methadone hydrochloride flux in equine intestinal mucosa.

Filed under: Methadone Clinics

J Vet Pharmacol Ther. 2012 Mar 19;
Linardi RL, Stokes AM, Andrews FM

Linardi, R. L., Stokes, A. M., Andrews, F. M. The effect of P-Glycoprotein on methadone hydrochloride flux in equine intestinal mucosa. J. vet. Pharmacol. Therap. doi: 10.1111/j.1365-2885.2012.01390.x. Methadone is an effective analgesic opioid that may have a place for the treatment of pain in horses. However, its absorption seems to be impaired by the presence of a transmembrane protein, P-glycoprotein, present in different tissues including the small intestine in other species. This study aims to determine the effect of the P-glycoprotein on methadone flux in the equine intestinal mucosa, as an indicator of in vivo drug absorption. Jejunum tissues from five horses were placed into the Ussing chambers and exposed to methadone solution in the presence or absence of Rhodamine 123 or verapamil. Electrical measurements demonstrated tissue viability for 120?min, and the flux of methadone across the jejunal membrane (mucosal to submucosal direction) was calculated based on the relative drug concentration measured by ELISA. The flux of methadone was significantly higher only in the presence of verapamil. P-glycoprotein was immunolocalized in the apical membrane of the jejunal epithelial cells (enterocytes), mainly located in the tip of the villi compared to cells of the crypts. P-glycoprotein is present in the equine jejunum and may possibly mediate the intestinal transport of methadone. This study suggests that P-glycoprotein may play a role in the poor intestinal absorption of methadone in vivo.
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In control?: ukrainian opiate substitution treatment patients strive for a voice in their treatment.

Filed under: Methadone Clinics

Subst Use Misuse. 2012 Apr; 47(5): 511-21
Golovanevskaya M, Vlasenko L, Saucier R

This article explores the burgeoning advocacy movement for methadone and buprenorphine treatment by patients, parents, and doctors in Ukraine, and their efforts to remake a system that infantilizes and controls patients into one where patients have a voice in their treatment. Through a review of gray literature and in-depth interviews with 28 patient-advocates and doctors in five Ukrainian cities between October 2009 and July 2010, this piece chronicles the emergence of opiate substitution treatment in Ukraine, describes successes toward patient-friendly treatment, and explores the institutionalized barriers that have pushed the patients to become advocates for their own treatment.
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Preclinical pharmacology and opioid combinations.

Filed under: Methadone Clinics

Pain Med. 2012 Mar; 13 Suppl 1: S4-S11
Pasternak GW

Although effective alone, opioids are often used in combination with other drugs for relief of moderate to severe pain. Guidelines for acute perioperative pain recommend the use of multimodal therapy for pain management, although combinations of opioids are not specifically recommended. Mu opioid drugs include morphine, heroin, fentanyl, methadone, and morphine 6?-glucuronide (M6G). Their mechanism of action is complex, resulting in subtle pharmacological differences among them and with unpredictable differences in their potency, effectiveness, and tolerability among patients. Highly selective mu opioids do not bind to a single receptor. Rather, they interact with a large number of mu receptor subtypes with different activation profiles for the various drugs. Thus, mu-receptor-based drugs are not all the same and it may be possible to utilize these differences for enhanced pain control in a clinical setting. These differences among the drugs raise the question of whether combinations might result in better pain relief with fewer side effects. This concept has already been demonstrated between two mu opioids in preclinical studies and clinical trials on other combinations are ongoing. This article reviews the current state of knowledge about mu opioid receptor pharmacology, summarizes preclinical evidence for synergy from opioid combinations, and highlights the complex nature of the mu opioid receptor pharmacology.
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Pro’s and Con’s of Methadone Clinics – Pro’s and Con’s of Methadone Clinics

Is the NHS Trying to Kill Rehab Clinics?

Filed under: Methadone Clinics

Methadone is popular among policy makers: it is credited with cutting crime and HIV infection rates and, with a simple prescription, vast numbers of drug addicts can be offered "addiction treatment". If used under medical supervision, methadone can be …
Read more on Huffington Post UK (blog)

State cites Duluth methadone clinic for violations

Filed under: Methadone Clinics

Duluth's only methadone clinic has fallen under tight scrutiny by the Minnesota Department of Human Services after the clinic was found to have 26 violations after an investigation fueled by complaints about the chemical-dependency treatment center.
Read more on Duluth News Tribune

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