Methadone Medical Maintenance: An Early 21st-Century Perspective

Novick, David M.; Salsitz, Edwin A.; Joseph, Herman; Kreek, Mary Jeanne

doi:10.1080/10550887.2015.1059225

Cited by 35 publications

(26 citation statements)

References 48 publications

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“…Elevated retention rates with a noteworthy decrease of illicit opiate use have been observed under methadone maintenance treatment [24][25][26][27]. In addition, there are reductions of other associated problems such as intravenous drug use, crime [28][29][30], and improvement of social functioning [31]. Later studies reported that prolonged methadone maintenance normalized the immune system function in heroin addicts [32], as well as the altered stress response [33].…”

Section: Methadonementioning

confidence: 99%

Present and Future Pharmacological Treatments for Opioid Addiction

Blanco-Gandía¹,

Montagud‐Romero²,

Rodrı́guez-Arias³

2020

Opioids - From Analgesic Use to Addiction

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When treating opioid addiction, multidisciplinary treatment is highly recommended, but pharmacotherapy plays a key role. Although the ideal goal is to achieve complete abstinence, an elevated percentage of opioid addicts requires maintenance substitution therapy. In the first section of this chapter, we will focus on the current pharmacological interventions to treat opioid addiction, such as methadone, buprenorphine, and naltrexone. Thanks to these medications, people are able to go back to their normal lives, by preventing withdrawal symptoms, reducing craving, and increasing their adherence to psychotherapy. In the second section, based on the evidence that addiction induces neuroadaptive changes in several neurotransmission systems, we focus on the wide range of possible pharmacological developments at the preclinical and clinical levels, which in recent years have increased considerably.

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Section: Methadonementioning

confidence: 99%

Present and Future Pharmacological Treatments for Opioid Addiction

Blanco-Gandía¹,

Montagud‐Romero²,

Rodrı́guez-Arias³

2020

Opioids - From Analgesic Use to Addiction

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“…These are methadone or buprenorphine / naloxone, taken on a daily basis. Methadone is a selective and long-lasting μ-agonist (although it also functions as an NMDA antagonist), whereas buprenorphine is a μ-partial agonist that also has κ-antagonist or partial agonist effects [23,83,84]. The antagonist naloxone is added to this buprenorphine formulation, as an abuse deterrent (i.e., to avoid diversion and injection).…”

Section: Existing Treatmentsmentioning

confidence: 99%

“…The antagonist naloxone is added to this buprenorphine formulation, as an abuse deterrent (i.e., to avoid diversion and injection). There are extensive long-term data showing considerable therapeutic benefit of chronic methadone and buprenorphine / naloxone maintenance, when used in high quality programs, providing sufficient doses of these medications [84,85]. …”

Section: Existing Treatmentsmentioning

confidence: 99%

Medications for substance use disorders (SUD): emerging approaches

Butelman

Kreek

2017

Expert Opinion on Emerging Drugs

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Introduction: Substance use disorders are a group of chronic relapsing disorders of the brain, which have massive public health and societal impact. In some disorders (e.g., heroin / prescription opioid addictions) approved medications have a major long-term benefit. For other substances (e.g., cocaine, amphetamines and cannabis) there are no approved medications, and for alcohol there are approved treatments, which are not in wide usage. Approved treatments for tobacco use disorders are available, and novel medications are also under study. Areas covered: Medication-based approaches which are in advanced preclinical stages, or which have reached proof-of concept clinical laboratory studies, as well as clinical trials. Expert opinion: Current challenges involve optimizing translation between preclinical and clinical development, and between clinical laboratory studies to therapeutic clinical trials. Comorbidities including depression or anxiety are challenges for study design and analysis. Improved pharmacogenomics, biomarker and phenotyping approaches are areas of interest. Pharmacological mechanisms currently under investigation include modulation of glutamatergic, GABA, vasopressin and κ-receptor function, as well as inhibition of monoamine re-uptake. Other factors that affect potential market size for emerging medications include stigma, availability of treatment settings, adoption by clinicians, and the prevalence of persons with SUD who are not actively treatment-seeking.

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“…In 1990, there was zero HIV antibody presence in another study involving an office-based pilot program of methadone maintenance [30]. In addition to harm reduction, there are also improvements in employment and in social functioning among methadone-maintained patients [5,6,26,31].…”

Section: Methadone Maintenance Effectivenessmentioning

confidence: 99%

Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”

Salsitz

Wiegand

2015

J. Med. Toxicol.

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Methadone maintenance therapy (MMT), a pharmacological treatment for opioid use disorder for the past 50 years, continues to remain controversial. Despite consistent and overwhelming evidence confirming the effectiveness and safety of MMT, misconceptions and myths persist regarding its legitimacy as a treatment for opioid addiction. This often results in the underutilization and limited availability of this treatment modality. Despite successful outcomes, the controversial nature of MMT, and the stigma experienced by the patients on methadone, has been a particularly difficult obstacle to overcome. We present the history of MMT, review the evidence for its efficacy in the treatment of opioid dependence, and explore the origins of the stigma and misconceptions related to MMT.

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Methadone Medical Maintenance: An Early 21st-Century Perspective

Cited by 35 publications

References 48 publications

Present and Future Pharmacological Treatments for Opioid Addiction

Present and Future Pharmacological Treatments for Opioid Addiction

Medications for substance use disorders (SUD): emerging approaches

Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”

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