Methadone maintenance treatment in China: perceived challenges from the perspectives of service providers and patients.

Filed under: Methadone Clinics

J Public Health (Oxf). 2012 Sep 19;
Wu F, Peng CY, Jiang H, Zhang R, Zhao M, Li J, Hser YI

BACKGROUND: China has recently adopted methadone maintenance treatment (MMT) as a national strategy to address the problem of drug abuse and related public health issues such as HIV and HCV infections. However, low enrollment and retention rates suggest that barriers may exist in MMT utilization. This study examined both patients’ perceptions and service providers’ perceptions of challenges in MMT implementation in China. METHODS: Four focus groups were conducted in two Chinese cities, Shanghai and Kunming, to explore the perceived and experienced barriers in MMT participation in China. All focus group discussions with participants were audio taped and transcribed. Atlas.ti 5.1 was used to analyze data. RESULTS: Service providers and patient participants reported positive experiences (e.g. effects of MMT in curbing withdrawal symptoms) but also expressed concerns about side effects and continued heroin use during MMT. They also identified barriers in participating and remaining in MMT, including affordability (fee requirement), acceptability (methadone as a substitution, dose, long-term nature), accommodation and accessibility (inconvenient operation hours, lack of transferability to other MMT clinics during travel) and competition between public health and public security. CONCLUSIONS: The present findings have implications for reconsidering the current MMT policies and practices in order to improve access, utilization and, ultimately, the effectiveness of MMT in China.
Source

Semantic priming and verbal learning in current opiate users, ex-users and non-user controls.

Filed under: Methadone Clinics

Hum Psychopharmacol. 2012 Sep; 27(5): 499-506
Battistella S, Constantinou N, Morgan CJ, Davis P, O’Ryan D, Curran HV

Despite a growing interest in memory functions of chronic drug users, investigation of semantic and episodic memory in opiate users is limited, and findings of studies have been inconsistent. The present study aimed to assess semantic memory and episodic memory for both drug-related and neutral stimuli in current and ex-users of opiates.Using an independent group design, we assessed semantic priming and verbal learning in 16 current opiate users on a methadone maintenance programme, 16 ex-opiate users in rehabilitation programmes and 16 healthy controls. The groups were matched on verbal IQ, age and employment status.We found that current and ex-users showed intact automatic and controlled semantic priming. Ex-users who had been abstinent for an average of 19?months showed a verbal learning impairment compared with controls. Both current and ex-users were impaired in recalling semantically unrelated words but unimpaired in recalling semantically related words.The findings suggest a relative lack of spontaneous use of mnemonic strategies and imply that highly structured information would help opiate-using clients in treatment. Copyright © 2012 John Wiley & Sons, Ltd.
Source

Opioid overdose prevention with intranasal naloxone among people who take methadone.

Filed under: Methadone Clinics

J Subst Abuse Treat. 2012 Sep 11;
Walley AY, Doe-Simkins M, Quinn E, Pierce C, Xuan Z, Ozonoff A

Overdose education and naloxone distribution (OEND) is an intervention that addresses overdose, but has not been studied among people who take methadone, a drug involved in increasing numbers of overdoses. This study describes the implementation of OEND among people taking methadone in the previous 30days in various settings in Massachusetts. From 2008 to 2010, 1553 participants received OEND who had taken methadone in the past 30days. Settings included inpatient detoxification (47%), HIV prevention programs (25%), methadone maintenance treatment programs (MMTP) (17%), and other settings (11%). Previous overdose, recent inpatient detoxification and incarceration, and polysubstance use were overdose risks factors common among all groups. Participants reported 92 overdose rescues. OEND programs are public health interventions that address overdose risk among people who take methadone and their social networks. OEND programs can be implemented in MMTPs, detoxification programs, and HIV prevention programs.
Source

The pharmacokinetics of methadone in adolescents undergoing posterior spinal fusion.

Filed under: Methadone Clinics

Paediatr Anaesth. 2012 Sep 14;
Stemland CJ, Witte J, Colquhoun DA, Durieux ME, Langman LJ, Balireddy R, Thammishetti S, Abel MF, Anderson BJ, Lonnqvist PA

BACKGROUND: The optimal methadone dosing regimen for children undergoing spinal surgery is uncertain because of sparse pediatric pharmacokinetic data and a paucity of analgesic effect data. The minimum effective analgesic concentration of methadone in opioid naïve adults is 58 mcg·L(-1) . METHODS: Adolescents aged 12-19 years undergoing idiopathic scoliosis correction were administered 0.25 mg·kg(-1) racemic methadone IV prior to surgical incision. Arterial blood samples for methadone assay were obtained at 0 min, 5 min, 10 min, 15 min, 20 min, 40 min, 1 h, 2 h, 4 h, 5 h, 6 h, 8 h, 10 h, 12 h, 24 h, and 48 h. Compartment analysis was undertaken using nonlinear mixed effects models. Parameter estimates were standardized to a 70-kg person using allometric models. RESULTS: A three-compartment linear disposition model best described observed time-concentration profiles. Population parameter estimates (between-subjects variability) were central volume (V1) 19.1 (126%) L 70 kg(-1) , peripheral volumes of distribution V2 65.5 (60%) L 70 kg(-1) , V3 485 (23%) L 70 kg(-1) , clearance (CL) 9.3 (11%) L·h(-1) ·70 kg(-1) , and inter-compartment clearances Q2 282 (95%) L·h(-1) 70 kg(-1) , Q3 139 (42%) L·h(-1) 70 kg(-1) . The terminal elimination half-life was 44.4 h. The mean observed methadone concentration was <58 mcg·L(-1) by the first hour after administration. CONCLUSIONS: Current pharmacokinetic parameter estimates in adolescents are similar to those reported in adults. Methadone undergoes rapid redistribution after bolus administration. This may result in plasma concentrations that provide inadequate analgesia postoperatively. We would suggest following the bolus (0.25 mg.kg(-1) ) with an infusion (0.1-0.15 mg·kg(-1) ·h(-1) for 4 h) during spinal surgery to ensure adequate plasma concentrations for 24 h. Source

New concerns surface about meth clinic proposal

Filed under: Methadone Clinics

One of the key figures behind a proposed methadone clinic in Old South is scheduled to appear next month before an Ontario College of Physicians and Surgeons disciplinary committee on allegations of “professional misconduct” and incompetence.
Read more on MetroNews Canada

Warren ZBA continues methadone clinic scrutiny

Filed under: Methadone Clinics

The zoning board met for the second consecutive month to review the planning board's approval of a methadone clinic to be owned and operated by CRC Recovery Inc. of Cupertino, Calif., in a building owned by Robert Emery Jr. on Short Street in Warren.
Read more on Courier-Gazette & Camden Herald (subscription)

Find More Methadone Clinics Information…

Comments are closed.