Abstracts
Methadone Maintenance Treatment (MMT) is an effective therapy for opioid-dependence; its use is based on a harm reduction philosophy and represents one of a range of treatment approaches for opioid-dependent individuals.
The medical literature supports MMT as a well established and cost-effective treatment for opioid-dependence that allows a return-to-normal physiological, psychological and societal functioning. The effectiveness of MMT is enhanced by psycho-social interventions such as contingency management and addressing other co-existing health and social needs. MMT saves lives and reduces violent and non-violent crime, drug use and the transmission of HIV, hepatitis C and other communicable diseases. For some people, MMT may continue for life, while others may eventually be able to discontinue and remain abstinent.
Methadone interacts with numerous drugs and prolongs the corrected QT interval (QTc) with risk of sudden cardiac death. It has a prolonged half-life and premature discharge of patients after methadone overdose may be fatal.
Each patient must be assessed, treated and monitored on an individual basis. Successful outcomes through MMT require knowledge, experience, vigilance, and diligence on the part of the physician, the patient and all of those involved in treatment.
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References
- Goldfrank L, Weisman RS, Errick JK, et al. A dosing nomogram for continuous infusion intravenous naloxone. Ann Emerg Med. 1986; 15(5): 566-70.
- LoVecchio F, Pizon A, Riley B, et al. Onset of symptoms after methadone overdose. Am J Emerg Med. 2007; 25(1): 57-9.
- Caplehorn JR, Drummer OH. Fatal methadone toxicity: signs and circumstances, and the role of benzodiazepines. Aust N Z J Public Health. 2002; 26(4): 358-62; discussion 362-3.
- http://www.atforum.com/SiteRoot/pages/addiction_resources/Drug_Interactions.pdf). www.hivclinic.ca/man/drugs_interact.html
- http://www.cpso.on.ca/policies/guidelines/default.aspx?id=1984 Abramson DW, Quinn DK, Stern TA. Methadone-Associated QTc Prolongation: A Case Report and Review of the Literature. Prim Care Companion J Clinic Psychiatric 2008; 10(6): 470-476
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