Advantages and Disadvantages of Methadone among Children and Adults: A Systematic Review and Meta-Analysis

Abstract

Background: Today, an increasing trend to methadone as an alternative maintenance treatment for opiate dependence in adults is observed; children for both intentional and accidental reasons are exposed to serious and fetal effects of methadone. We aimed to investigate effects of methadone on children and sexual functioning among adults in Iranian population. Materials and Methods: An extensive search was done in databases of Medline, EMBASE, Scopus, Cochrane, and Web of Science until August 2018. Two independent researchers screened articles, and categorized them based on the evaluated outcomes and overall effect size was presented. After excluding the duplicated, irrelevant and low-quality articles, eligible ones were enrolled in the meta-analysis. Finally, pooled effect size was presented as standardized mean difference (SMD) or pooled prevalence with 95% confidence interval (95% CI). Results: Methadone was found to be more effective than morphine on neonatal abstinence syndrome. The first four most common symptoms of methadone poisoning were loss of consciousness (81%), sleepiness (72%), meiotic pupils (76%), vomiting (56%), and Apnea (48%). The overall prevalence rate of sexual disorders and erectile dysfunction was 66.3% and 77.5%, respectively. The subjects in methadone group were over 2.5-fold more likely to use condom during intercourse (p<0.001). The methadone therapy could lead to a significant reduction in orgasm functioning (p<0.001), and a significant improvement in libido (p=0.001). The methadone maintenance treatment (MMT) significantly resulted in decreased orgasm function and improved libido in males. Conclusion: Evidence suggests a positive impact of methadone maintenance treatment on risky sexual behaviors. Regarding the methadone poisoning effect on children, people should be informed by health care providers about serious and fetal effects on children.