Predictors of Diabetes Mellitus and Abnormal Blood Glucose in Patients Receiving Opioid Maintenance Treatment.

Am J Addict. 2013 Jul; 22(4): 411-416
Fareed A, Byrd-Sellers J, Vayalapalli S, Drexler K, Phillips L

Buprenorphine is a partial opioid agonist and may have less impact on the risk of developing diabetes mellitus (DM) compared to full opioid agonists like methadone.We conducted an observational retrospective study to investigate the predictable factors for impaired glucose tolerance and predisposition to DM in two groups of opiate addicts receiving long-term methadone maintenance treatment (MMT) [n?=?58] or buprenorphine maintenance treatment (BMT) [n?=?61].In our cohort, being African American, hepatitis C positive status, elevated AST, and ALT, and being on methadone were significantly correlated to being diagnosed with DM. Among all those factors, being on methadone was most significantly related to being diagnosed with DM (?(2) ?=?3.9888, p-value?=?.0458). The BMI was the only factor that was significantly correlated to having abnormal A1c level (?(2) ?=?6.4229, p-value?=?.0113).Buprenorphine may be less likely to contribute to the development of DM than methadone. More research is needed to understand the link between opioids and DM. (Am J Addict 2013;22:411-416).
HubMed – Methadone

Impact of Cannabis Use during Stabilization on Methadone Maintenance Treatment.

Am J Addict. 2013 Jul; 22(4): 344-351
Scavone JL, Sterling RC, Weinstein SP, Van Bockstaele EJ

Illicit drug use, particularly of cannabis, is common among opiate-dependent individuals and has the potential to impact treatment in a negative manner.To examine this, patterns of cannabis use prior to and during methadone maintenance treatment (MMT) were examined to assess possible cannabis-related effects on MMT, particularly during methadone stabilization. Retrospective chart analysis was used to examine outpatient records of patients undergoing MMT (n?=?91), focusing specifically on past and present cannabis use and its association with opiate abstinence, methadone dose stabilization, and treatment compliance.Objective rates of cannabis use were high during methadone induction, dropping significantly following dose stabilization. History of cannabis use correlated with cannabis use during MMT but did not negatively impact the methadone induction process. Pilot data also suggested that objective ratings of opiate withdrawal decrease in MMT patients using cannabis during stabilization.The present findings may point to novel interventions to be employed during treatment for opiate dependence that specifically target cannabinoid-opioid system interactions. (Am J Addict 2013;22:344-351).
HubMed – Methadone

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