Testing a Fall Risk Model for Injection Drug Users.

Filed under: Methadone Detox

Nurs Res. 2012 Sep 18;
Pieper B, Templin TN, Goldberg A

BACKGROUND:: Fall risk is a critical component of clinical assessment and has not been examined for persons who have injected illicit drugs and are aging. OBJECTIVES:: The aim of this study was to test and develop the Fall Risk Model for Injection Drug Users by examining the relationships among injection drug use, chronic venous insufficiency, lower extremity impairments (i.e., decreased ankle range of motion, reduced calf muscle endurance, and leg pain), age and other covariates, and the Tinetti balance and gait total score as a measure of fall risk. METHODS:: A cross-sectional comparative design was used with four crossed factors. Standardized instruments were used to assess the variables. Moderated multiple regression with linear and quadratic trends in age was used to examine the nature of the relationship between the Tinetti balance and gait total and age and the potential moderating role of injection drug use. A prespecified series of models was tested. RESULTS:: Participants (n = 713) were men (46.9%) and women with a mean age of 46.26 years and primarily African American (61.7%) in methadone treatment centers. The fall risk of a 48-year-old leg injector was comparable with the fall risk of a 69-year-old who had not injected drugs. Variables were added to the model sequentially, resulting in some lost significance of some when they were explained by subsequent variables. Final significant variables in the model were employment status, number of comorbidities, ankle range of motion, leg pain, and calf muscle endurance. DISCUSSION:: Fall risk was associated with route of drug use. Lower extremity impairments accounted for the effects of injection drug use and chronic venous insufficiency on risk for falls. Further understanding of fall risk in injection users is necessary as they age, attempt to work, and participate in activities.
Source

Alginate and Chitosan Foam combined with Electromembrane extraction for Dried Blood Spot analysis.

Filed under: Methadone Detox

Anal Chem. 2012 Sep 19;
Eibak LE, Hegge AB, Rasmussen KE, Pedersen-Bjergaard S, Gjelstad A

Samples of 10 µl whole blood containing citalopram, loperamide, methadone, and sertraline as model substances were spotted on alginate and chitosan foams as sampling media. After drying and storage at room temperature the punched out dried blood spot and the foam was dissolved in 300 µl of 1 mM HCl. With alginate foam as sampling medium the analytes dissolved completely after 3 minutes. Enrichment and cleanup was performed with electromembrane extraction for 10 minutes. The analytes were collected in 21 µl of 10 mM formic acid as acceptor phase and the extracts were analyzed by LC-MS. Sample preparation of blood spots on commercial cards was also performed (Whatman FTA DMPK and Agilent Bond Elute DMS) using elution procedures recommended by the manufacturers. The recoveries obtained with the commercial cards were lower for most of the model analyts compared to the recoveries obtained with alginate and chitosan foams as sampling media. The procedure used for Agilent Bond Elute DMS showed higher recoveries than the procedure used for Whatman FTA DMPK-A but the time needed for sample preparation was significantly longer (nearly 2 h). The stability of the model substances on the alginate foam was acceptable within 50 days of storage. The limit of quantification (LOQ) defined as S/N=10, was 1.2, 5.5, 2.0, and 5.3 ng/ml for citalopram, loperamide, methadone, and sertraline, respectively. Linear calibration graphs were obtained in the range 17.5 – 560 ng/ml with r2 values 0.983-0.995 and the relative standard deviations were below 20%.
Source

Dextromethorphan Attenuated Inflammation and Combined Opioid Use in Humans Undergoing Methadone Maintenance Treatment.

Filed under: Methadone Detox

J Neuroimmune Pharmacol. 2012 Sep 19;
Chen SL, Lee SY, Tao PL, Chang YH, Chen SH, Chu CH, Chen PS, Lee IH, Yeh TL, Yang YK, Hong JS, Lu RB

Recent studies show that proinflammatory cytokines might be related to the development of opioid dependence (physiological, psychological, or both). In a double-blind, randomly stratified clinical trial investigating whether add-on dextromethorphan (60-120 mg/day) attenuated inflammation and the combined use of opioids in heroin-dependent patients undergoing methadone maintenance treatment, we evaluated whether inflammation is related to the progression of opioid dependence. All participants (107 heroin-dependent patients and 84 nondependent healthy controls) were recruited from National Cheng Kung University Hospital. Their plasma cytokine levels were measured to evaluate the effect of add-on dextromethorphan. Plasma TNF-? and IL-8 levels were significantly higher in long-term heroin-dependent patients than in healthy controls (p?Source

[Reimbursement of opiate substitution drugs to militaries in 2007].

Filed under: Methadone Detox

Encephale. 2012 Sep; 38(4): 304-9
d’Argouges F, Desjeux G, Marsan P, Thevenin-Garron V

The use of psychoactive drugs by militaries is not compatible with the analytical skills and self-control required by their jobs. Military physicians take this problem into consideration by organising systematic drugs screening in the French forces. However, for technical reasons, opiates are not concerned by this screening with the agreement of the people concerned. The estimated number of militaries who use an opiate substitute may be an approach of heroin consumption in the French forces. This study describes buprenorphine and methadone reimbursements made during 2007 by the national military healthcare centre to French militaries.Each French soldier is affiliated to a special health insurance. The national military healthcare centre has in its information system, all the data concerning drug reimbursement made to French military personnel. This is a retrospective study of buprenorphine and methadone reimbursements made during 2007 by the military healthcare centre, to militaries from the three sectors of the French forces, and from the gendarmerie and joint forces. Only one reimbursement of one of these two drugs during this period allowed the patient to be included in our study. Daily drug dose and treatment steadiness profile have been calculated according to the criteria of the French monitoring centre for drugs and drug addiction. The criteria of the National guidelines against frauds have been used to identify misuse of these drugs. Doctors’ shopping behaviour has also been studied. Finally, the nature of the prescriber and the consumption of other drugs in combination with opiate substitute have been analysed.One hundred and eighty-one military consumers of opiate substitute drugs (167 men and 14 women) participated. This sample included people from the three sectors of the French forces as well as from the gendarmerie and from the joint forces. The average age of the consumers was 26.6 years (20-42 years). The average length of service was 6.1 years (maximum 22 years service). One hundred and fifty-nine militaries had been delivered buprenorphine, 15 had been delivered methadone and seven had been delivered both. The prevalence of opiate substitute drug consumption by the militaries (52 per 100,000) is lower than in general population. According to the criteria of the National Healthcare Insurance, this population is not affected by abuse or fraud behaviour. Doctors’ shopping behaviour is unusual. Opiate substitutes are prescribed by general physicians in 88% of issues. Only one prescriber was a military physician. An analysis of reimbursement of some drugs associated with opiate substitute has been made. The sampled military consume more psychoactive drugs (anxiolytics, antidepressants, hypnotics) than the French population under opiate substitution.In our observation, the military physician is almost always excluded the process of substitution. His/her different responsibilities of care, but also in determining the working aptitude, lead to dissimulation behaviour by the militaries. The difficulty for military physicians is to identify such consumption. They have to evaluate the capacity to work through a physical and psychological examination.
Source

Methadone Detox – As seen on A&E’s Intervention…A dignified and compassionate Methadone Detox center. We can help you detox from Methadone painlessly. Recover from Methadone addiction comfortably in the number one Detox in the country, specializing in painless Detox from Methadone. www.summerhousedetoxcenter.com 888-DETOX-123

Related Methadone Detox Information…

Comments are closed.