Feasibility of Double-Blind Clinical Trials with Oral Diacetylmorphine: A Randomized Controlled Phase II Study in an Inpatient Setting.

Filed under: Methadone Treatment

Eur Addict Res. 2012 Jul 31; 18(6): 279-287
Colom Farran J, Casas M, Pérez de Los Cobos J, Del Río M, Roncero C, Castells X, Valero S, Eiroa-Orosa FJ, Batlle F, Trujols J

The aim of this study was to evaluate the feasibility of conducting double-blind controlled randomized clinical trials using twice-a-day immediate-release oral diacetylmorphine (DAM) in heroin-dependent patients, by means of measuring the capacity of oral DAM to block opiate withdrawal and clinicians’ ability to distinguish it from morphine and methadone. This was a randomized, phase II, double-blind, multicenter pilot study comparing immediate-release oral DAM, slow-release oral morphine and oral methadone administered twice a day during 10 days. Forty-five heroin-dependent patients were randomly assigned to these three treatment groups in an inpatient regime. Patients were stabilized with a mean of 350 mg (SD = 193) of immediate-release oral DAM, 108 mg (SD = 46.2) of slow-release oral morphine and 40 mg (SD = 17.9) of methadone. No statistically significant differences were found between any studied medication in clinical outcome. Neither patients nor clinicians were able to identify the administered medication. This study shows the feasibility of double-blind clinical trials using b.i.d. immediate-release oral DAM allowing further phase III clinical trials in the process of introducing oral DAM as a medication for heroin-dependent patients not responding to standard maintenance treatments.
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Prescription medication exchange patterns among methadone maintenance patients.

Filed under: Methadone Treatment

Drug Alcohol Depend. 2012 Jul 30;
Caviness CM, Anderson BJ, de Dios MA, Kurth M, Stein M

BACKGROUND: Exchange of prescription medications is a significant public health problem particularly among substance abusing populations. Little is known about the extent of medication sharing and receiving behaviors in methadone maintenance treatment (MMT) populations and the factors associated with such behaviors. METHODS: We examined rates, and factors associated with past year medication sharing and receiving practices of 315 MMT smokers who had enrolled in a clinical trial of smoking cessation. Sequential logistic regression models estimated the effect of demographic and substance use variables on the probability of sharing or receiving medications. RESULTS: Participants averaged 40years of age, and 49% were male. Among persons prescribed medications, 19.9% reported sharing. Nearly 40% had used medication not prescribed to them. Pain medications, sleep medications, and sedatives, were most commonly shared and received. Younger age was a significant predictor of both sharing medications (OR=0.92, 95%CI 0.88; 0.96, p<.01) and receiving medications (OR=0.94, 95%CI 0.92; 0.97, p<.01). Financial hardship (OR=2.05, 95%CI 1.13; 3.72, p<.05), and recent use of heroin (OR=5.59, 95%CI 1.89; 16.57, p<.01) or cocaine (OR=3.70, 95%CI 1.48; 9.28, p<.05), were also independently associated with a significantly higher likelihood of receiving prescription drugs of abuse. CONCLUSIONS: The high prevalence of prescription medication sharing and receiving behaviors among persons in MMT often include substances with abuse potential and suggest the need for comprehensive approaches for minimizing this phenomenon. Source

Improvement of quality of life following 6 months of methadone maintenance therapy in Malaysia.

Filed under: Methadone Treatment

Subst Abuse Treat Prev Policy. 2012 Aug 1; 7(1): 32
Baharom N, Hassan MR, Ali N, Shah SA

ABSTRACT: BACKGROUND: Methadone Maintenance Therapy (MMT) is one of the popular choices for drug substitution therapy and is fairly new in Malaysia. Aside from its role in harm reduction against HIV infection, MMT programme may potentially enhances clients’ quality of life. This study aims to identify the impact of MMT programme on clients’ quality of life after 6 months in treatment and to explore factors that may be associated with changes in their quality of life. METHODS: In this retrospective report review, 122 subjects from 2 government MMT clinics were selected from the district of Tampin, Negeri Sembilan, Malaysia. The raw score from the WHO Quality of Life questionnaire (WHOQOL-BREF), at baseline and 6 months after therapy were collected and converted to 0-100 scale form to give quality of life scores for four domains; physical, psychological, social relationships and environment. Other variables of interest were socio-demography, age when joining MMT programme, age and duration of illicit drug use, HIV and Hepatitis C status, and the Opiate Treatment Index (OTI) score on drug use, sexual and social aspect at the baseline. Statistical analysis used the SPSS version 16. RESULTS: There was significant improvement in all four domains of quality of life, after 6 months of MMT. The largest improvement was for psychological domain (mean score difference 15.54 +/- 20.81). Multivariable linear regression analysis showed that, for the physical domain, there was no significant predictor. For both the psychological and social domains, having tertiary education is a significant predictor for improvement in both aspects of quality of life. Negative HIV status is associated with improvement for the environment domain. CONCLUSIONS: There was a significant short term improvement in the quality of life of MMT clients who stayed in the programme for at least 6 months in the district of Tampin, Negeri Sembilan, Malaysia.
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Innocent victims: Drug dependence begins early for some Mainers

Filed under: Methadone Treatment

It was painful knowing her baby's withdrawal symptoms were caused by her own methadone treatment, said Lena, who spoke on condition her real name not be used. But to continue to use illicit drugs could have caused more serious health issues for her …
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Methadone often deadly

Filed under: Methadone Treatment

“This isn't methadone coming out of the methadone clinics for addiction treatment,” said Russel Falck, an associate professor at Wright State University and assistant director of the Center for Interventions, Treatment and Addictions Research (CITAR …
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