Setting 4 sites in New York State, USA. Patients 135 heterosexual couples (mean age 37 y) in which men were entering outpatient treatment for AL (71 couples) or ODA (64 couples). Inclusion criteria for men included DSM-III-R criteria for psychoactive substance abuse or dependence. Exclusion criteria included either partner being in a methadone maintenance programme or having a major mental diso...

Background: Drug overdose continues to be the most common cause of acute poisoning worldwide. There has been a substantial increase in drug overdose incidence and prevalence over the past decade, probably as a result of the emergence of new synthetic designer drugs. The purpose of this study is to describe the clinical and epidemiological characteristics of patients with acute drug intoxication...

OBJECTIVE To evaluate the impact of introduction of supervision of methadone dosing on deaths related to overdose of methadone in Scotland and England between 1993 and 2008 while controlling for increased prescribing of methadone. DESIGN Analysis of annual trends in deaths related to overdose of methadone in relation to defined daily doses of methadone prescribed. SETTING Scotland and Engla...

This study describes two bioanalytical methods for the quantitation of methadone enantiomers in dried matrix spots using high performance liquid chromatography coupled to tandem mass spectrometry (HPLC-MS/MS) and supercritical (HPSFC-MS/MS). Dried were obtained by spotting 10 µL each sample fluid on a Whatman paper. Methadone its main metabolite, EDDP, extracted with 100 methanol subsequently i...

BACKGROUND Interindividual variability in methadone disposition remains unexplained, and methadone accidental overdose in pain therapy is a significant public health problem. Cytochrome P4502B6 (CYP2B6) is the principle determinant of clinical methadone elimination. The CYP2B6 gene is highly polymorphic, with several variant alleles. CYP2B6.6, the protein encoded by the CYP2B6*6 polymorphism, d...

This paper provides a detailed analysis of the 2-year outcomes for 351 drug misusers allocated on an intention-to-treat basis to methadone maintenance or methadone reduction treatments. Both groups showed substantial reductions in their use of illicit drugs and in other outcome areas. However, whereas most methadone maintenance patients received maintenance, only about one third of those alloca...

Methadone is a clinically used opioid agonist that is oxidatively metabolized by cytochrome P450 (CYP) isoforms to a stable metabolite, EDDP. Methadone is a chiral drug administered as the racemic mixture of (R)-(-)- and (S)-(+)-methadone, but (R)-methadone is the active isomer. The cytochrome P450 (CYP) isoform involved in methadone's metabolism is thought to be CYP3A4, but human drug-drug int...

BACKGROUND AND OBJECTIVES Breastfeeding, a public health priority, improves outcomes for infants. Methadone is dispensed as a racemic mixture; R-methadone is the active enantiomer. Pharmacologic data for R-methadone in breastmilk could improve risk-benefit decision-making for treatment of lactating women. This study estimated infant exposure to R- and S-methadone via breastmilk by theoretic inf...

BACKGROUND Retention in treatment is a key indicator of methadone treatment success. The study aims to identify factors that are associated with retention. OBJECTIVES To determine retention in treatment at 12 months for Irish opiate users in methadone substitution treatment and to indicate factors that increase the likelihood of retention. METHODS National cohort study of randomly selected ...

BACKGROUND Methadone maintenance treatment (MMT) is a key element in treatment for opiate addiction; however concerns about the diversion of methadone remain. More current empirical data on methadone diversion are required. This research investigated the market for diverted methadone in Merseyside, UK, in order to provide a case study which can be transferred to other areas undertaking methadon...