Letter to the Editor: On the Usefulness of Therapeutic Drug Monitoring of Methadone

Eap, Chin B.

doi:10.1159/000019006

Cited by 8 publications

(2 citation statements)

References 33 publications

(47 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An appropriate and rather high dose of methadone has been linked with higher rates of success in substitution treatment [21][22][23][24] . The relatively low doses of methadone used in Switzerland have already been underlined in a survey of the Swiss literature [25] .…”

Section: Discussionmentioning

confidence: 99%

Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

Pelet¹,

Doll²,

Huissoud³

et al. 2005

Eur Addict Res

View full text Add to dashboard Cite

Using data from the Public Health Service, we studied the demographic and clinical characteristics of 1,782 patients enrolled in methadone maintenance treatment (MMT) during 2001 in the Swiss Canton of Vaud, comparing our findings with the results of a previous study from 1976 to 1986. In 2001, most patients (76.9%) were treated in general practice. Mortality is low in this MMT population (1%/year). While patient age and sex profiles were similar to those found in the earlier study, we did observe a substantial increase in the number of patients and the number of practitioners treating MMT patients, probably reflecting the low-threshold governmental policies and the creation of specialized centers. In conclusion, easier access to MMT enhances the number of patients, but new concerns about the quality of management emerge: benzodiazepine as a concomitant prescription; low rates of screening for hepatitis B, C and HIV, and social and psychiatric preoccupations.

show abstract

Section: Discussionmentioning

confidence: 99%

Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

Pelet¹,

Doll²,

Huissoud³

et al. 2005

Eur Addict Res

View full text Add to dashboard Cite

show abstract

“…Urine methadone analysis cannot help as it is qualitative and results only indicate if the patient had taken the medication. One of the major benefits of TDM is being able to monitor adherence to the dose prescribed and has been recommended [231][232][233]. However, a very wide range of trough and peak plasma concentrations (65 ng/mL to as high as 1255 ng/mL) [234] have been reported, making plasma concentrations difficult to interpret.…”

Section: Methadonementioning

confidence: 99%

What the lab can and cannot do: clinical interpretation of drug testing results

Kapur¹,

Aleksa²

2020

Critical Reviews in Clinical Laboratory Sciences

View full text Add to dashboard Cite

Urine drug testing is one of the objective tools available to assess adherence. To monitor adherence, quantitative urinary results can assist in differentiating "new" drug use from "previous" (historical) drug use. "Spikes" in urinary concentration can assist in identifying patterns of drug use. Coupled chromatographic-mass spectrometric methods are capable of identifying very small amounts of analyte and can make clinical interpretation rather challenging, specifically for drugs that have a longer half-life. Polypharmacy is common in treatment and rehabilitation programs because of co-morbidities. Medications prescribed for comorbidities can cause drug-drug interaction and phenoconversion of genotypic extensive metabolizers into phenotypic poor metabolizers of the treatment drug. This can have significant impact on both pharmacokinetic (PK) and pharmacodynamic properties of the treatment drug. Therapeutic drug monitoring (TDM) coupled with PKs can assist in interpreting the effects of phenoconversion. TDM-PKs reflects the cumulative effects of pathophysiological changes in the patient as well as drug-drug interactions and should be considered for treatment medications/drugs used to manage pain and treat substance abuse. Since only a few enzyme immunoassays for TDM are available, this is a unique opportunity for clinical laboratory scientists to develop TDM-PK protocols that can have a significant impact on patient care and personalized medicine. Interpretation of drug screening results should be done with caution while considering pharmacological properties and the presence or absence of the parent drug and its metabolites. The objective of this manuscript is to review and address the variables that influence interpretation of different drugs analyzed from a rehabilitation and treatment programs perspective.

show abstract

Psychobiological responses to drug cues before and after methadone intake in heroin-dependent patients: A pilot study

Walter

Wiesbeck

Bloch

et al. 2008

European Neuropsychopharmacology

View full text Add to dashboard Cite

Letter to the Editor: On the Usefulness of Therapeutic Drug Monitoring of Methadone

Cited by 8 publications

References 33 publications

Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

Methadone Maintenance Treatment in the Swiss Canton of Vaud: Demographic and Clinical Data on 1,782 Ambulatory Patients

What the lab can and cannot do: clinical interpretation of drug testing results

Psychobiological responses to drug cues before and after methadone intake in heroin-dependent patients: A pilot study

Contact Info

Product

Resources

About