DSM-III Personality Type and Dose Levels in Methadone Maintenance Patients

Treece, Catherine; Nicholson, Barbara

doi:10.1097/00005053-198010000-00006

Cited by 21 publications

(10 citation statements)

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“…The authors concluded that the high rate in ASPD probably occurred through behavioural mechanisms, including irresponsible and reckless behaviours, poor impulse control and low harm avoidance, which could have also related to other risk factors such as polydrug use. Positive findings in other small studies have included a link between schizoid PD and a requirement for higher methadone dose levels [81], and ASPD impairing response to pharmacotherapy for adjunctive cocaine use in methadone patients [82]. A range of findings relate to patients in methadone maintenance programmes.…”

Section: Medicalmentioning

confidence: 95%

“…Medical problems, general [76] HIV risk behaviours [78] HIV infection [79] Psychiatric distress [65,76] Depression [76] Alcoholism [76] Social Legal problems [76] Poorer social functioning [64] More current crime [64] Treatment effects Methadone maintenance Greater heroin dependence [64] Higher methadone dosage [81] Less response to pharmacotherapy for additional cocaine use [82] Other…”

Section: Medicalmentioning

confidence: 99%

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Personality disorder and drug use: a review

Seivewright

Daly

1997

Drug and Alcohol Review

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The concept of personality disorder (PD) is more relevant in the clinical management of drug users than other approaches to personality assessment. A problem in diagnosis is separating behaviours inherent in the activity of drug misuse from true evidence of PD, especially the anti-social type (ASPD), and rating instruments vary in their ability to do this. Nevertheless, the available evidence suggests that approximately two-thirds of drug users in treatment have PD, with ASPD the most common. Studies have mainly been in opiate users, while the prevalence of PD may be lower across the range of drugs, and in non-treatment settings. PD has been found to be associated with a range of complications and adverse outcomes in drug use, including psychiatric problems, poor social functioning, dropout from treatment, and increased HIV risk behaviours and infection rates. Outcomes for ASPD individuals in methadone maintenance treatment appear reasonable, however, and it may be that early recourse to such treatment is the most practical option for many PD opiate users, a potential criticism being that this does not directly address the PD problems.

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Section: Medicalmentioning

confidence: 95%

Section: Medicalmentioning

confidence: 99%

Personality disorder and drug use: a review

Seivewright

Daly

1997

Drug and Alcohol Review

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“…The author indicates a possibly favorable psychiatric effect of methadone that is independent of drug use. 82 In another study, subjects with major psychopathology required higher methadone dosages for stabilization (mean 60 mg per day) compared to the control subjects (30 mg p day). The authors noted that the "best methadone dose" is not only that which stops heroin use, but also that which contributes to stabilization of psychiatric disease (i.e., a higher dose than control).…”

Section: Methadone Dose and Psychiatric Patientsmentioning

confidence: 96%

“…In one of the earliest observations of increased methadone dosages in dually diagnosed patients, Treece found a strong relationship between psychopathology and methadone dosage. 82 Schizoid disorders required a mean daily methadone dosages of 87.4 mg compared to a mean daily dosages of 35.7 mg for the control patients (a 145% increase for dually diagnosed patients). All patients were heroin-free.…”

Section: Methadone Dose and Psychiatric Patientsmentioning

confidence: 98%

Psychotherapeutic Benefits of Opioid Agonist Therapy

Tenore

2008

Journal of Addictive Diseases

119

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Opioids have been used for centuries to treat a variety of psychiatric conditions with much success. The so-called "opium cure" lost popularity in the early 1950s with the development of non-addictive tricyclic antidepressants and monoamine oxidase inhibitors. Nonetheless, recent literature supports the potent role of methadone, buprenorphine, tramadol, morphine, and other opioids as effective, durable, and rapid therapeutic agents for anxiety and depression. This article reviews the medical literature on the treatment of psychiatric disorders with opioids (notably, methadone and buprenorphine) in both the non-opioid-dependent population and in the opioid-dependent methadone maintenance population. The most recent neurotransmitter theories on the origin of depression and anxiety will be reviewed, including current information on the role of serotonin, N-Methyl d-Aspartate, glutamate, cortisol, catecholamine, and dopamine in psychiatric disorders. The observation that methadone maintenance patients with co-existing psychiatric morbidity (so called dual diagnosis patients) require substantially higher methadone dosages by between 20% and 50% will be explored and qualified. The role of methadone and other opioids as beneficial psychiatric medications that are independent of their drug abuse mitigating properties will be discussed. The mechanisms by which methadone and other opioids can favorably modulate the neurotransmitter systems controlling mood will also be discussed.

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“…Indications are found that the individual dose re quirements differ in relationship with the presence of both state (axis-I pathology in DSM IIIR) and trait (axis-II pathology in DSM IIIR) psychopathology. Higher metha done doses are given in cases where personality disorders, marked by odd or eccentric behaviour and social with drawal or isolation (cluster A, axis II in DSM III), are found [17], In a large (n = 106) study higher prevalence of emotional distress and anxiety was found in patients with a higher methadone dose [18]. It has also been postulated that addicts who show aggressiveness, besides certain psychopathological symptoms, require a higher methadone dose [19].…”

Section: Introductionmentioning

confidence: 99%

Opiate Craving and the Presence of Psychopathology

1997

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In this paper the final results are presented as a part of a larger study, which was designed to explore which parameters are involved in continued opiate craving among patients in methadone maintenance therapy (MMT). Twenty long-term opiate addicts currently enrolled in MMT were assessed for correlations between opiate craving, methadone pharmacokinetics and the presence of current psychopathology. In this presentation the correlation between the level of opiate craving and the presence of psychopathology is described. In a previous publication no significant correlations at the group level were found between opiate craving and methadone pharmacokinetics. Psychopathology was measured using the General Health Questionnaire, the Symptom Checklist and the Addiction Severity Index. Craving was measured using the experience sampling method. In this relatively small random sample, no significant correlation between the level of craving and the presence of current psychopathology could be established. From the findings of the present and two previous studies we conclude that both methadone pharmacokinetics and general psychopathology cannot explain high craving among opiate addicts in MMT. Other factors influencing the individual experience of craving, such as personality characteristics or cue exposure, should be investigated.

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DSM-III Personality Type and Dose Levels in Methadone Maintenance Patients

Cited by 21 publications

References 0 publications

Personality disorder and drug use: a review

Personality disorder and drug use: a review

Psychotherapeutic Benefits of Opioid Agonist Therapy

Opiate Craving and the Presence of Psychopathology

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