This study was concerned with determining the effects that varying the methadone-dispensing frequencies during mandatory clinic visits had on patients' retention in treatment and behavioral adjustment.

Background: The theme of the position and experiences of pregnant women in the context of methadone maintenance treatment has not yet been thoroughly examined, the aim was to contribute to break the taboo concerning this topic and help to destigmatize these women. Goals: To map the situation of pregnant women in MMT and to alert to therapeutic specificity of these women. Methods: Semi-structured interview and analysis of the medical documentation were used to obtain the data, observation method, qualified estimate and clinical case reports. Data were processed through content analysis. File: The research group consists of 7 patients who were treated in the Department of Adictology 1st Faculty of Medicine, Charles University and General University Hospital in Prague, who gave birth to at least one child between 2004 and 2014. Results: The analysis shows that during their pregnancy women reduce the use of illicit drugs and tobacco. Despite these pregnancies are usually not planned, it was observed that in these women the pregnancy occured in a situation when the respondents were stabilized in both the treatment and in their social situation. The experience of pregnancy played a stimulating role for dose reduction or direction to abstinence. The reasons are usually the confrontation with the NAS of their child...

Addiction to opiates is a complex public health issue affecting thousands of Canadians. Methadone Maintenance Treatment (MMT) is considered the gold standard in Canada, and the world, for treating opiate dependence. In the past, Canadian research into opiate addiction and the effectiveness of MMT has mostly focused on larger cities: Toronto, Montreal, and Vancouver. This community based research study employed a mixed method approach to gain understanding of the experiences and satisfaction with MMT and other health services available to opiate users in Belleville, Ontario (population 48,000). Surveys (N = 53), focus groups, participant-observation methods and key informant interviews were used to gather data. The results provide an overall picture of the quality of life for opiate users and MMT clients, the quality of care clients receive, and the perceptions of community members regarding MMT. Challenges related to smaller locales are identified along with recommendations for improving MMT health services. / UOIT

The methadone maintenance treatment population suffers from high rates of comorbid psychiatric and substance use disorders. Despite a more than 40-year treatment history, not all patients are satisfied with methadone treatment and more than half of the patients complain of significant inter-dose withdrawal at least some of the time. The objectives of this research were to investigate the pharmacological response to methadone under the influence of comorbid major depressive disorder and smoking; and to identify factors other than physical withdrawal symptoms that can differentiate patients based on their complaints of dissatisfaction with treatment. In Study 1, seven depressed methadone maintenance patients experienced more opioid withdrawal symptomatology over a 24-hour methadone-dosing interval than 10 nondepressed methadone patients. Depression severity was significantly correlated with trough opioid withdrawal severity. This suggests that depression or depressive symptoms are related to reported opioid withdrawal. In Study 2, many factors other than physical opioid withdrawal symptoms were able to differentiate patients who were satisfied with treatment (holders, n=25), partially satisfied with treatment (partial holders, n=35), and not satisfied with treatment(nonholders, n=30). Results suggested that these patient satisfaction groups cluster differently depending on physical opioid withdrawal, mood, psychological distress, and personality. Nonholders experienced more physical withdrawal symptoms, craving for opioids, and negative drug effects. Holders had less psychological distress and experienced less negative mood states than the other groups. Partial holders had less agreeable personalities compared to patients in the other groups. In Study 3, opioid and nicotine withdrawal symptoms and effects were measured in 40 methadone-maintained patients who were current smokers during trough and peak methadone effects, both pre and post-nicotine administration. Cigarette smoking enhanced opioid withdrawal suppression during the peak methadone condition, methadone attenuated nicotine withdrawal, and methadone and nicotine shared many of the same main effects, suggesting that smoking and methadone effects may be inseparable dimensions. In summary, the results of these studies suggest that in addition to physical symptoms, mood related factors are important to opioid withdrawal perception and that the mood factors and drug interactions can impact on a patient’s perception of satisfaction with methadone treatment.

The methadone maintenance treatment population suffers from high rates of comorbid psychiatric and substance use disorders. Despite a more than 40-year treatment history, not all patients are satisfied with methadone treatment and more than half of the patients complain of significant inter-dose withdrawal at least some of the time. The objectives of this research were to investigate the pharmacological response to methadone under the influence of comorbid major depressive disorder and smoking; and to identify factors other than physical withdrawal symptoms that can differentiate patients based on their complaints of dissatisfaction with treatment. In Study 1, seven depressed methadone maintenance patients experienced more opioid withdrawal symptomatology over a 24-hour methadone-dosing interval than 10 nondepressed methadone patients. Depression severity was significantly correlated with trough opioid withdrawal severity. This suggests that depression or depressive symptoms are related to reported opioid withdrawal. In Study 2, many factors other than physical opioid withdrawal symptoms were able to differentiate patients who were satisfied with treatment (holders, n=25), partially satisfied with treatment (partial holders, n=35), and not satisfied with treatment(nonholders, n=30). Results suggested that these patient satisfaction groups cluster differently depending on physical opioid withdrawal, mood, psychological distress, and personality. Nonholders experienced more physical withdrawal symptoms, craving for opioids, and negative drug effects. Holders had less psychological distress and experienced less negative mood states than the other groups. Partial holders had less agreeable personalities compared to patients in the other groups. In Study 3, opioid and nicotine withdrawal symptoms and effects were measured in 40 methadone-maintained patients who were current smokers during trough and peak methadone effects, both pre and post-nicotine administration. Cigarette smoking enhanced opioid withdrawal suppression during the peak methadone condition, methadone attenuated nicotine withdrawal, and methadone and nicotine shared many of the same main effects, suggesting that smoking and methadone effects may be inseparable dimensions. In summary, the results of these studies suggest that in addition to physical symptoms, mood related factors are important to opioid withdrawal perception and that the mood factors and drug interactions can impact on a patient’s perception of satisfaction with methadone treatment.

Previous research into the subsequent effects of prenatal methadone exposure has primarily focused on neurological changes and short term physical development. While there have been some studies of behavioural development, only short term effects have been investigated. The present research therefore aimed to assess longer term behavioural development of offspring exposed to methadone gestationally, lactationally or both. Methadone was provided in the drinking water of drug-treated rat dams during gestation (2.39mg/kg/day) and lactation (2.86mg/kg/day). The four conditions were: non-exposure/control (N = 24), gestational-exposure (N = 20), lactational-exposure (N = 24), and combined-exposure (N = 21). As well as several measures of pregnancy characteristics, offspring postnatal physical development was assessed at 30, 60 and 120 days after birth. Behavioural assessments were also made at these ages by means of an open-field, Y maze and emergence apparatus. There were no significant differences in physical development. Maternal methadone exposure during gestation reduced the number of rat dams that became (or remained) pregnant. In the offspring, there was increased activity in lactationally-exposed rats through into adulthood. Anxiety was increased in the combined-exposure condition, primarily in adolescent males. The significant longer term effects of earlier methadone on the rats’ behavioural development supported the need for more research into this hitherto relatively neglected area. More information about effects of methadone exposure on anxiety and activity, as well as on social functioning and motor coordination could be useful for understanding potential risk factors in the ever growing methadone-exposed population, and thus suggesting best practice for methadone maintenance programmes.

Thesis (M.S.W.)--University of Hong Kong, 1998. / Includes bibliographical references (leaves 114-123).

Thesis (M. Soc. Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 90-100).

Thesis (M.Soc.Sc.)--University of Hong Kong, 1988. / Also available in print.

Thesis (M.Soc.Sc.)--University of Hong Kong, 2000. / Includes bibliographical references (leaves 90-100) Also available in print.