Prospective comparative assessment of buprenorphine overdose with heroin and methadone: Clinical characteristics and response to antidotal treatment

Mégarbane, Bruno; Buisine, A.; Jacobs, Frédéric; Résière, Dabor; Chevillard, L; Vicaut, Éric; Baud, Frédéric J.

doi:10.1016/j.jsat.2010.01.006

Cited by 51 publications

(29 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In the study of Mégarbane et al ., tendencies to commit suicide have been reported in the Methadone poisoning patients more than the other cases. [13] Brands et al ., have also shown that the psychiatric problems in the Methadone poisoned patients were considerably more than the other patients. [14] In Cowan's study, hospitalization rate of Methadone poisoned patients in the psychiatric unit has been significantly more than the normal ones.…”

Section: Discussionmentioning

confidence: 99%

Methadone toxicity in a poisoning referral center

et al. 2013

View full text Add to dashboard Cite

Objective:Methadone poisoning can occur accidentally or intentionally for suicide or homicide purposes. The aim of this study was to evaluate the epidemiological and clinical manifestations of Methadone poisoning.Methods:A descriptive analytical study was performed from 2010 to 2012 in the poisoning emergency and clinical toxicology departments of Noor hospital affiliated with Isfahan University of Medical Sciences (Isfahan, Iran). All patients with Methadone poisoning within this period of time were investigated. Different variables were recorded in a checklist.Findings:A total of 385 patients were studied. About 85.7% had ingested only Methadone and 14.3% had ingested other medications with Methadone. Mean ± standard deviation of the age was 32.1 ± 15 years (range: 1-90). Most of the patients were male (76.4%). Nearly 40% of the patients were narcotic addicts, 25.5% were addicts under surveillance of Methadone maintenance therapy centers and 34.5% were non-addicts. Intentional poisoning was observed in most of the patients (57.7%). Most of the patients had a low level of consciousness on admission (58.2%). Respiratory depression and hypotension was observed in 35.6% and 12.7% of the cases as the most common symptoms. Regarding vital signs, there was a significant difference in respiratory rate on admission among different evaluated groups (P = 0.02). Length of hospital stay was 18.79 ± 0.72 h (range: 4-240 h, median: 15 h). About 57 patients (25.8%) from the intentionally poisoned patients and 19 patients (12.3%) from the unintentionally poisoned patients had a history of psychiatric disorder (P = 0.001). Most of the patients survived without complications.Conclusion:Addiction, age, gender, attempt to suicide and a history of psychiatric disorder were of the most important factors effective in Methadone poisoning, which should be considered in the public training and prevention of poisoning.

show abstract

Section: Discussionmentioning

confidence: 99%

Methadone toxicity in a poisoning referral center

et al. 2013

View full text Add to dashboard Cite

show abstract

“…The clinical signs in non-fatal buprenorphine overdoses are very similar to those of heroin or methadone [12] however the mechanisms seem to be different as the subjects do not always respond to naloxone treatment. In cases of co-ingestion of bensodiazepines, treatment with flumazenil may reverse respiratory depression.…”

mentioning

confidence: 99%

Toxicological and pathological findings in a series of buprenorphine related deaths. Possible risk factors for fatal outcome

Seldén

Ahlner

Druid

et al. 2012

Forensic Science International

View full text Add to dashboard Cite

“…7), is effective at reducing craving for heroin and illicit opiate use. However, substitution therapy is fettered by an inherent risk for continued dependence symptomology (8) and relapse, in addition to potential adverse effects caused by continued opioid use (9)(10)(11). Heroin blockade with naltrexone, an opioid receptor antagonist, has also proven effective in the management of heroin addiction, with extended-release injection formulations and implants that improve compliance.…”

mentioning

confidence: 99%

Dynamic vaccine blocks relapse to compulsive intake of heroin

Schlosburg

Vendruscolo

Bremer

et al. 2013

Proc. Natl. Acad. Sci. U.S.A.

View full text Add to dashboard Cite

Heroin addiction, a chronic relapsing disorder characterized by excessive drug taking and seeking, requires constant psychotherapeutic and pharmacotherapeutic interventions to minimize the potential for further abuse. Vaccine strategies against many drugs of abuse are being developed that generate antibodies that bind drug in the bloodstream, preventing entry into the brain and nullifying psychoactivity. However, this strategy is complicated by heroin's rapid metabolism to 6-acetylmorphine and morphine. We recently developed a "dynamic" vaccine that creates antibodies against heroin and its psychoactive metabolites by presenting multihaptenic structures to the immune system that match heroin's metabolism. The current study presents evidence of effective and continuous sequestration of brain-permeable constituents of heroin in the bloodstream following vaccination. The result is efficient blockade of heroin activity in treated rats, preventing various features of drugs of abuse: heroin reward, drug-induced reinstatement of drug seeking, and reescalation of compulsive heroin selfadministration following abstinence in dependent rats. The dynamic vaccine shows the capability to significantly devalue the reinforcing and motivating properties of heroin, even in subjects with a history of dependence. In addition, targeting a less brainpermeable downstream metabolite, morphine, is insufficient to prevent heroin-induced activity in these models, suggesting that heroin and 6-acetylmorphine are critical players in heroin's psychoactivity. Because the heroin vaccine does not target opioid receptors or common opioid pharmacotherapeutics, it can be used in conjunction with available treatment options. Thus, our vaccine represents a promising adjunct therapy for heroin addiction, providing continuous heroin antagonism, requiring minimal medical monitoring and patient compliance.immunotherapy | antinociception | progressive ratio

show abstract

Prospective comparative assessment of buprenorphine overdose with heroin and methadone: Clinical characteristics and response to antidotal treatment

Cited by 51 publications

References 37 publications

Methadone toxicity in a poisoning referral center

Methadone toxicity in a poisoning referral center

Toxicological and pathological findings in a series of buprenorphine related deaths. Possible risk factors for fatal outcome

Dynamic vaccine blocks relapse to compulsive intake of heroin

Contact Info

Product

Resources

About