Methadone‐related deaths in Western Australia 1993–99

Ernst, E.; Bartu, Anne; Popescu, Aurora; Ilett, Kenneth F.; Hansson, Robert C; Plumley, Noel

doi:10.1111/j.1467-842x.2002.tb00188.x

Cited by 50 publications

(32 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Increased opioid effect Increased opioid effect Ernst et al (2002), Kintz (2002aKintz ( , 2002b, Kilicarslan and Sellers (2000), Reynaud et al (1998) tool that can inform treatment planning. Ideally, clinicians should use a version of the ASI tailored to women and pregnancy (Comfort, Zanis, Whiteley, Kelly-Tyler, & Kaltenbach, 1999).…”

Section: Antifungal Agentmentioning

confidence: 98%

Treatment of opioid-dependent pregnant women: Clinical and research issues

Jones

Martin

Heil

et al. 2008

Journal of Substance Abuse Treatment

168

167

View full text Add to dashboard Cite

This article addresses common questions that clinicians face when treating pregnant women with opioid dependence. Guidance, based on both research evidence and the collective clinical experience of the authors, which include investigators in the Maternal Opioid Treatment: Human Experimental Research (MOTHER) project, is provided to aid clinical decision making. The MOTHER project is a double-blind, double-dummy, flexible-dosing, parallel-group clinical trial examining the comparative safety and efficacy of methadone and buprenorphine for the treatment of opioid dependence in pregnant women and their neonates. The article begins with a discussion of appropriate assessment during pregnancy and then addresses clinical management stages including maintenance medication selection, induction, and stabilization; opioid agonist medication management before, during, and after delivery; pain management; breast-feeding; and transfer to aftercare. Lastly, other important clinical issues including managing co-occurring psychiatric disorders and medication interactions are discussed.

show abstract

Section: Antifungal Agentmentioning

confidence: 98%

Treatment of opioid-dependent pregnant women: Clinical and research issues

Jones

Martin

Heil

et al. 2008

Journal of Substance Abuse Treatment

168

167

View full text Add to dashboard Cite

show abstract

“…First, although heroin use is greatly reduced during MMT, methadone does not prevent co-use of heroin or other opioids (Gossop, Marsden, Stewart, & Kidd, 2003). Many heroin users engage in polysubstance use, especially co-use of central nervous system (CNS) depressants such as benzodiazepines, which have been identified as a major risk factor in fatal overdoses for those on MMT (Ernst et al, 2002). This co-use of heroin and other CNS depressant drugs while attempting to stabilize on a prescribed dose of methadone creates a potential for respiratory depression and an increased risk for accidental overdose.…”

Section: Mortality Associated With Entry Into Heroin Treatmentmentioning

confidence: 99%

Mortality in heroin users 3 years after naltrexone implant or methadone maintenance treatment

Tait

Ngo

Hulse

2008

Journal of Substance Abuse Treatment

View full text Add to dashboard Cite

“…Consistent with this principle is evidence showing that the period shortly following methadone initiation appears to be associated with increased risk of overdose and other adverse events. 27,37,108 Although the half-life of methadone is usually assumed to be approximately 1 day, and is rarely outside a range of 15 to 60 hours, in some reports the half-life is as high as 120 hours.…”

Section: Initiation Of Methadonementioning

confidence: 99%

Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Society

Chou

Cruciani

Fiellin

et al. 2014

The Journal of Pain

206

188

View full text Add to dashboard Cite

Methadone is used for the treatment of opioid addiction and for treatment of chronic pain. The safety of methadone has been called into question by data indicating a large increase in the number of methadone-associated overdose deaths in recent years that has occurred in parallel with a dramatic rise in the use of methadone for chronic pain. The American Pain Society and the College on Problems of Drug Dependence, in collaboration with the Heart Rhythm Society, commissioned an interdisciplinary expert panel to develop a clinical practice guideline on safer prescribing of methadone for treatment of opioid addiction and chronic pain. As part of the guideline development process, the American Pain Society commissioned a systematic review of various aspects related Clinical practice guidelines are ''guides'' only and may not apply to all patients and all clinical situations. As part of a shared decision-making approach, it may be appropriate for the clinician to inform a patient that a particular recommendation may not be applicable, after considering all circumstances pertinent to that individual. This article is based on research conducted at the Oregon Evidence-based Practice Center (now the Pacific Northwest Evidence-based Practice Center) with funding from the American Pain Society (APS to safety of methadone. After a review of the available evidence, the expert panel concluded that measures can be taken to promote safer use of methadone. Specific recommendations include the need to educate and counsel patients on methadone safety, use of electrocardiography to identify persons at greater risk for methadone-associated arrhythmia, use of alternative opioids in patients at high risk of complications related to corrected electrocardiographic QTc interval prolongation, careful dose initiation and titration of methadone, and diligent monitoring and follow-up. Although these guidelines are based on a systematic review, the panel identified numerous research gaps, most recommendations were based on low-quality evidence, and no recommendations were based on high-quality evidence.Perspective: This guideline, based on a systematic review of the evidence on methadone safety, provides recommendations developed by a multidisciplinary expert panel. Safe use of methadone requires clinical skills and knowledge in use of methadone to mitigate potential risks, including serious risks related to risk of overdose and cardiac arrhythmias. M ethadone is a synthetic opioid used for the treatment of opioid addiction and for treatment of chronic pain. 15,61 The safety of methadone has been called into question by data indicating a large increase in the number of methadone-associated overdose deaths.38 This increase appears largely related to the dramatic rise in the use of methadone for chronic pain, though a small proportion of deaths occur in patients treated for opioid addiction. 21,37,68,76,91,103 Methadone poisoning deaths in the United States increased steadily from about 800 in 1999 to a high of about 5,500 in 2007; th...

show abstract

Methadone‐related deaths in Western Australia 1993–99

Abstract: Objectives: To describe methadone-related deaths in Western Australia from 1993 to 1999 and determine differences between deaths in methadone maintenance treatment

Cited by 50 publications

References 16 publications

Treatment of opioid-dependent pregnant women: Clinical and research issues

Treatment of opioid-dependent pregnant women: Clinical and research issues

Mortality in heroin users 3 years after naltrexone implant or methadone maintenance treatment

Methadone Safety: A Clinical Practice Guideline From the American Pain Society and College on Problems of Drug Dependence, in Collaboration With the Heart Rhythm Society

Contact Info

Product

Resources

About