What is Methadone?

I have included below notes for a presentation I have given on the use of methadone.  Feel free to contact me if this brings up any questions you may want to have answered.

Connock, M. (2007). Methadone and buprenorphine for the management of opioid dependence: a systematic review and economic evaluation. Health Technology Assessment, 11(9), 1-190.

·        A review of the clinical effectiveness and cost effectiveness of BMT vs MMT.

·        Focused on short-term interventions (under one year)

·        Monitored opiate use using urinalysis

·        Participants: young men with opiate or heroin dependence without significant co morbid psychological disorders

·        Results: both BMT and MMT were superior to placebo or no treatment.

·        Mortality with BMT may be lower

·        Overall, MMT was found to be slightly more effective and less costly than BMT.

  

Schottenfeld, R. S. (2005).  Methadone versus buprenorphine with contingency

Management or performance feedback for cocaine and opioid dependence.  American Journal of Psychiatry, 162(2), 340-349. 

·        Treatment guidelines for patients with concurrent cocaine and heroin dependence are not available

·        Cocaine abuse found in 42% of users in methadone treatment

·        No efficacious medication for cocaine dependence exists

·        Some animal research shows that BMT may be effective in treatment of cocaine abuse

·        Contingency management can motivate cocaine abstinence (giving monetary vouchers for clean urine tests)

·        Daily opioid treatment

·        Results: Subjects who received methadone remained in treatment significantly longer, showed fewer positive drug tests, and achieved longer periods of abstinence.

·        Results: Contingency management versus performance feedback showed no significant differences

·        Results: BMT does not have particular benefits for concurrent cocaine dependence

·        Limitations: a high proportion of subjects did not provide a single drug-free urine tests - so contingency management was not adequately tested (25% for methadone, 45% for BMT)