Effect of Methadone Maintenance Therapyon Anthropometric Indices in Opioid Dependent Patients

Montazerifar, Farzaneh; Karajibani, Mansour; Lashkaripour, Kobra

doi:10.5812/ijhrba.4968

Cited by 19 publications

(23 citation statements)

References 13 publications

(17 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…However, the proportion of those in the obese category doubled. As shown by Montazerifar et al ( 3 ), the percentages of underweight, overweight and obese patients were 27.3%, 18.2% and 3.6%, respectively before methadone treatment, and 12.7%, 18.2% and 7.2% at the end of the 8 weeks. A subsequent US study of 69 methadone patients by Fenn et al ( 4 ) also found a significant increase in BMI from admission to follow up.…”

Section: Introductionmentioning

confidence: 72%

“…Okruhlica and Slezakova ( 5 ) hypothesized that the weight gain of their patients in opiate substitution treatment is most probably a consequence of the changes in their lifestyle and not the result of direct adverse pharmacological effect of methadone medication. The findings by Okruhlica and Slezakova ( 5 ), if replicated, are of crucial medical importance because they suggest that the rapid weight increase such as the twofold increase of patients within the obese category observed by Montazerifar et al ( 3 ) within the time span as short as only 8 weeks does not continue beyond the first or the second year of methadone treatment and is perhaps more related to changes in lifestyle than to pharmacological properties of methadone.…”

Section: Introductionmentioning

confidence: 94%

“…Similarly, the Polish study by Szpanowska-Wohn et al ( 2 ) noted an increase in average body mass from 71.7 kg to 75.7 kg within 9 months following entry to methadone treatment. A study by Montazerifar et al ( 3 ) noted a significant increase in BMI already within the first 8 weeks on admission to methadone treatment. Within the 8 weeks, the average weight of patients treated by Montazerifar’s team showed a statistically significant increase from 61.4 kg on admission to treatment to 65.3 kg which corresponded to a BMI increase from 21.4 to 23.0.…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Body Composition Changes Associated With Methadone Treatment

Sadek

Chiu

Cernovsky

2016

Int J High Risk Behav Addict

View full text Add to dashboard Cite

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.

show abstract

Section: Introductionmentioning

confidence: 72%

Section: Introductionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Body Composition Changes Associated With Methadone Treatment

Sadek

Chiu

Cernovsky

2016

Int J High Risk Behav Addict

View full text Add to dashboard Cite

show abstract

“…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 .…”

mentioning

confidence: 99%

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

Elman

Howard²,

Borodovsky

et al. 2020

Sci Rep

View full text Add to dashboard Cite

Metabolic hormones stabilize brain reward and motivational circuits, whereas excessive opioid consumption counteracts this effect and may impair metabolic function. Here we addressed the role of metabolic processes in the course of the agonist medication-assisted treatment for opioid use disorder (OUD) with buprenorphine or methadone. Plasma lipids, hemoglobin A1C, body composition, the oral glucose tolerance test (oGtt) and the Sweet taste test (Stt) were measured in buprenorphine-(n = 26) or methadone (n = 32)-treated subjects with OUD. On the whole, the subjects in both groups were overweight or obese and insulin resistant; they displayed similar oGtt and Stt performance. As compared to methadone-treated subjects, those on buprenorphine had significantly lower rates of metabolic syndrome (MetS) along with better values of the high-density lipoproteins (HDL). Subjects with-vs. without MetS tended to have greater addiction severity. correlative analyses revealed that more buprenorphine exposure duration was associated with better HDL and opioid craving values. in contrast, more methadone exposure duration was associated with worse triglycerides-, HDL-, blood pressure-, fasting glucose-and hemoglobin A1C values. Buprenorphine appears to produce beneficial HDL-and craving effects and, contrary to methadone, its role in the metabolic derangements is not obvious. our data call for further research aimed at understanding the distinctive features of buprenorphine metabolic effects vis-à-vis those of methadone and their potential role in these drugs' unique therapeutic profiles. Opioid use disorder (OUD) is an ominous public health problem afflicting about 16 million people worldwide 1. In the US, OUD constitutes the seventh cause for disability-adjusted life-years 2-4 ; including opioids' propensity 5 for the excessive body weight gain (BWG) and its medical sequelae in the form of the 'Metabolic Syndrome' (MetS) 5-7 , that is to say, a cluster of interrelated cardiometabolic risk factors comprised of insulin resistance, impaired glucose tolerance, dyslipidemia, abdominal adiposity and hypertension 8-10. Consequently, even though medication-assisted treatment (MAT) via opioid agonist replacement with long-acting opioids namely, buprenorphine and methadone, usually yields positive clinical outcomes in terms of overdose mortality, infectious diseases, crime, and societal ties 11-14 concerns have been raised about further worsening of the metabolic status 5. There are several lines of evidence that link OUD to metabolic derangements. With regard to genetic antecedents, the TCF7L2 gene codes a transcription factor implicated 15,16 in non-insulin-dependent

show abstract

“…During recent years, methadone/buprenorphine maintenance therapy (MMT/BMT) has been one of the effective methods in controlling substance abuse and risky behaviors in Iran (1,2). However, one of the major challenges of this therapeutic approach is treatment retention rate (3).…”

mentioning

confidence: 99%