Body Composition Changes Associated With Methadone Treatment

Abstract

Background:Methadone is associated with a statistically significant increase in BMI in the first 2 years of treatment.Objectives:To evaluate the changes of body composition (bone mass, % fat, % muscle mass, % water, and basal metabolic rate) related to this increase.Patients and Methods:Changes in body composition were monitored, via bioelectrical impedance, in 29 patients in methadone treatment for opiate dependency (age 18 to 44, mean = 29.3, SD = 7.0, 13 men, 16 women).Results:Within one year from admission to treatment, a statistically significant (t-tests, P < 0.05) increase was noted in their body mass index (BMI), % of body fat, average body mass, and average basal metabolic rate, and relative decrease in their % of muscle mass and % of bone mass. Neither absolute bone mass nor muscle mass changed significantly.Conclusions:Physicians involved in care of methadone patients should recommend dietary and lifestyle changes to improve their overall health.

Metabolic and Addiction Indices in Patients on Opioid Agonist Medication-Assisted Treatment: A Comparison of Buprenorphine and Methadone

“…Significant correlations between methadone drug exposure duration and HDL, MAP, fasting glucose and hemoglobin A1C values are in accord with an earlier study showing that methadone dose was significantly correlated with the odds of having NIDDM 68,69 . Furthermore, our findings extend to the methadone exposure duration the prior report on the predictability of MetS based solely on the exposure time 5 .…”

“…MetS represents a complex pathophysiological condition that may develop in OUD patients [54][55][56][57] even independent of MAT, from increased caloric intake, decreased energy expenditure owing to reduced physical activity or a combination of both 8,21 . This assertion is however undermined by: (1) preponderance of studies reporting low body weight in short half-life opioid (e.g., heroin) abusers who are not on MAT agonist therapy [58][59][60][61] even in the face of glucoregulatory abnormalities [62][63][64] ; and (2) excessive BWG consistently noted in OUD patients following the initiation of methadone [65][66][67][68][69][70][71] and to a lesser degree buprenorphine 6,7,72 treatment. Nonetheless, the debate about the issue is still ongoing 73 with a number of reports on the opposite directionality of the metabolic responses 74,75 , including hemoglobin A1C level decreases in buprenorphine-maintained NIDDM patients 76 in conjunction with heightened insulin sensitivity in methadone-treated OUD patients 77 as well as hypoglycemia in patients receiving chronic analgesia with methadone 78 .…”

“…Methadone-induced hypoglycemia was also noted in a rodent model 79 . Paucity of comprehensive metabolic status assessments 5 or of a proper control adjusting for OUD and for an ongoing opioid agonist therapy 6,69,73 may partially explain the divergent results. Other potential reasons include the types of opioid receptors engaged 36 , their ligands 79 , the dose 27,80 , acute vs. prolonged opioid exposure 36 and peripheral 81,82 vs. central 36,40 sites of action.…”

Characteristics of Medicaid recipients in Methadone Maintenance Treatment: A comparison across the lifespan

“…Further, the psychosocial needs of older adults frequently differ from those of younger cohorts, including changes in employment status, income, family relationships, social roles, and social connectedness (Charles & Carstensen, 2010). Finally, metabolic changes associated with MMT are common; MMT users are more likely to develop a metabolic condition (Mysels & Sullivan, 2010;Vallecillo et al, 2017) as well as an increase in BMI (Fenn, Laurent, & Sigmon, 2015;Sadek, Chiu, & Cernovsky, 2016). However, the degree to which conditions such as diabetes, hypercholesterolemia, hypertension and obesity potentially vary by age and duration of treatment has yet to be investigated.…”

The Effects of Probiotic Supplementation on Opioid-Related Disorder in Patients under Methadone Maintenance Treatment Programs

“…One of the most worrying post-addiction problems is malnutrition in all walks of life, whether in industrial or nonindustrial human societies [ 2 ]. In addition, overall body mass has been shown to increase predominantly due to an increase in the proportion of body fat upon methadone treatment [ 3 ]. A national pilot study was conducted in Iran in 2002 to assess the feasibility of reducing drug-related adverse effects, leading to the establishment of private and public centers for methadone treatment [ 4 ].…”