Association between methadone dose and concomitant cocaine use in methadone maintenance treatment: a register-based study

Abstract

BackgroundConcomitant cocaine use is a major problem in clinical practice in methadone maintenance treatment (MMT) and may interfere with successful treatment. Data from European methadone populations is sparse. This register-based study sought to explore the association between prescribed methadone dose and concomitant cocaine and heroin use in the methadone population of Basel City.MethodsThe study included 613 methadone patients between April 1, 2003 and March 31, 2004. Anonymized data was taken from the methadone register of Basel City. For analysis of the prescribed methadone dose distribution, the patient sample was split into three methadone dosage groups: a low dose group (LDG) (n = 200; < 60 mg/day), a medium dose group (MDG) (n = 273; 60 to 100 mg/day), and a high dose group (HDG) (n = 140; > 100 mg/day). Concomitant drug use was based on self-report.ResultsAnalysis showed a significant difference in self-reported cocaine use between groups (p < 0.001). Patients in the LDG reported significantly fewer cocaine consumption days compared to the MDG (p < 0.001) and the HDG (p < 0.05). Patients in the HDG reported significantly fewer heroin consumption days than those in the LDG (p < 0.01) and the MDG (p < 0.001). In logistic regression analysis, cocaine use was significantly associated with heroin use (OR 4.9).ConclusionsCocaine use in methadone patients may be associated with heroin use, which indicates the importance of prescribing appropriate methadone dosages in order to indirectly reduce cocaine use.

The newer Opioid Agonist Treatment with lower substitutive opiate doses is associated with better toxicology outcome than the older Harm Reduction Treatment

“…They found that the percentage of urines negative for cocaine or for opiates and cocaine simultaneously did not differ by dose. Noteworthy, Baumeister et al [45] found that patients in the low dose group had significantly fewer cocaine consumption days than patients in the currently recommended dose range >60 mg/day. Moreover, in line with previous studies [45–47], we found a positive association between heroin and cocaine use in HRT and OAT patients.…”

“…Noteworthy, Baumeister et al [45] found that patients in the low dose group had significantly fewer cocaine consumption days than patients in the currently recommended dose range >60 mg/day. Moreover, in line with previous studies [45–47], we found a positive association between heroin and cocaine use in HRT and OAT patients. Our findings suggest that methadone maintenance has an important role in restraining most of the cases of pre-existing concurrent cocaine abuse.…”

Dosis de metadona y su relación con calidad de vida, satisfacción, psicopatología, rendimiento cognitivo y consumo adicional de sustancias no prescritas

“…En cuanto a la cocaína, no aparecieron diferencias en función de las dosis. Estos datos difieren de lo encontrado en otros estudios, que encuentran menor consumo de heroína y mayor de cocaína en quienes reciben dosis altas, y al contrario, en quienes reciben dosis bajas (Baumeister et al, 2014).…”

Childhood Trauma, Cognitive Emotion Regulation and Motivation for Behavior Change Among Clients of Opioid Substitution Treatment With and Without Past Year Synthetic Cathinone Use During Therapy

“…The local phenomenon of opioid dependent patients' SC use enables the study of SC-specific consumption determinants in a clinical sample. Of the many possible factors underlying substance use during OST -e.g., shorter treatment duration (Li et al, 2012), a medium 60-100 mg/day medication dose (Baumeister et al, 2014), low treatment attendance, drug using friends, family conflicts (Sullivan et al, 2014), male gender , younger age (Amiri et al, 2018), or the quality and supportiveness of the social network (Shen et al, 2018) -this paper focuses on the presumed impact of unresolved childhood trauma, with special emphasis placed on individual patterns of cognitive emotion regulation as related to stressful live events.…”