Months Of Methadone Maintenance Treatment Research Articles

Frontal Lobe Functions, Demoralization, Depression and Craving as Prognostic Factors and Positive Outcomes of Patients with Heroin Use Disorder Receiving 6 Months of Methadone Maintenance Treatment.

Methadone maintenance therapy (MMT) is a well-established and effective treatment for heroin use disorders. Whether frontal lobe function and demoralization serve as suitable prognostic and outcome assessment factors remains unknown. A quasi-experimental study was conducted with a single-group repeated-measures design at a medical center and mental hospital in Taiwan. We enrolled 70 participants (39 completed treatments and 31 dropped out). Frontal lobe function, demoralization, depression, and craving at three time points were analyzed. There were differences between patients who completed the treatment (n = 39) and those who did not (n = 31). Thirty-nine patients completed the treatment (average age, 45.5 years; 89.7% men; average duration of heroin use, 27.21 years; MMT, 38.18 mg/day). Post-MMT (6 months), frontal lobe function, demoralization, depression, and craving significantly improved. Dropouts had higher frontal lobe function, lower demoralization, higher craving, younger age, and earlier onset age than patients who completed the pretest treatment. Clinicians should be aware of the severity of demoralization. Clinicians may select suitable patients for MMT by assessing frontal lobe function, demoralization, craving, age, and onset age. A 6-month course of MMT improved demoralization, frontal lobe function, depression, and addiction. Six months of treatment was more effective than 3 months. Suitable patient identification and continuous treatment are important in MMT.

Changes in the Quality of Life of Outpatients in Methadone Maintenance Treatment Clinics in Kathmandu Valley

Introduction: Methadone maintenance treatment (MMT) is widely accepted treatment option for the opioid dependent individuals. The evaluation of the quality of life represents the assessment of the effectiveness of the treatment program. The study aimed to explore the impact of MMT program on clients’ quality of life in the first 6 months of treatment. Methods: A total of 63 patients were recruited from the 5 different methadone clinics of Kathmandu valley. A prospective follow-up design was used. The semi-structured pro forma was filled up. To assess quality of life, WHO Quality of Life questionnaire (WHOQOL-BREF, 26-item version) was used. The tool was used to assess the quality of life at the baseline and after 6 months of enrollment in MMT program. Results: Following 6 months of methadone maintenance treatment of opioid dependent individuals, significant improvements (P<0.001) were observed in all measured domains of quality of life i.e. physical, psychological, environmental and social. The least improvement was noted in the social domain. Conclusion: Methadone maintenance treatment is helpful in improving the quality of the life of the opioid dependent individuals in MMT clinics.

Changes in the Quality of Life of Outpatients in Methadone Maintenance Treatment Clinics in Kathmandu Valley

Introduction Methadone maintenance treatment (MMT) is widely accepted treatment option for the opioid dependent individuals. The evaluation of the quality of life represents the assessment of the effectiveness of the treatment program. The study aimed to explore the impact of MMT program on clients’ quality of life in the first 6 months of treatment.
 MethodsA total of 63 patients were recruited from the 5 different methadone clinics of Kathmandu valley. A prospective follow-up design was used. The semi-structured pro forma was filled up. To assess quality of life, WHO Quality of Life questionnaire (WHOQOL-BREF, 26-item version) was used. The tool was used to assess the quality of life at the baseline and after 6 months of enrollment in MMT program.
 ResultsFollowing 6 months of methadone maintenance treatment of opioid dependent individuals, significant improvements (P<0.001) were observed in all measured domains of quality of life i.e. physical, psychological, environmental and social. The least improvement was noted in the social domain.
 ConclusionMethadone maintenance treatment is helpful in improving the quality of the life of the opioid dependent individuals in MMT clinics.

Longitudinal behavioral and fMRI-based assessment of inhibitory control in heroin addicts on methadone maintenance treatment.

The objective of the present study was to determine whether methadone maintenance treatment (MMT) in heroin-dependent patients affects inhibitory control, whether any MMT-induced changes correlate with methadone dose and MMT duration, and whether these changes depend on the psychological characteristics of patients, such as depression, anxiety and impulsivity. Response inhibition in the GO/NO-GO test was combined with functional magnetic resonance imaging (fMRI) scanning data to examine whether MMT affects inhibitory control in 21 heroin-addicted patients who had already undergone at least three months of MMT. Patients were evaluated one year prior to and after the MMT period. Participants exhibited no difference in their GO/NO-GO reaction time and accuracy rate, or in their false alarm rate under NO-GO conditions. However, increased activation was detected in numerous brain regions in their 12-month fMRI scans, although these were not in the frontal-striatal loop. Increased fMRI activation in the left precentral gyrus and superior temporal gyrus were negatively correlated with the daily methadone dose and total methadone dose during the one-year study period. In conclusion, these results suggested that MMT over one year does not significantly change the behavioral indicators of inhibitory control function in heroin-dependent patients. The increase in activation leads to the hypothesis that MMT over one year may increase cognitive inhibitory control, which may be the result of the combined negative effect of methadone and the positive effect of functional recovery after withdrawal of heroin.

Gender and Age Effects on the Trajectory of Depression in Opioid Users during Methadone Maintenance Treatment.

Both heroin use and depression are significant health problems. Methadone maintenance treatment (MMT) can be of great benefit to heroin users. However, changes in the level of depression in heroin users during MMT are not clear. Gender and age are also important factors in the development of depression, and whether gender and age moderate changes in depression in heroin users during MMT warrants further study. This study aimed to explore: (1) the trajectory of depression in opioid users during MMT and (2) the moderating effects of gender and age on the trajectory of depression in opioid users receiving MMT. A total of 294 intravenous heroin users were recruited into this 9-month observational study. The level of depression was measured at the intake interview and at follow-up interviews every 3 months. A latent growth model was used to analyze the trajectory of the level of depression among the participants. Depression improved rapidly during the first 3 months of MMT and slowly after the first 3 months in both the female and male heroin users. There was no gender difference in the level of depression at each follow-up point. The level of depression in the female heroin users decreased faster than that in the male heroin users. In addition, the level of depression in the younger heroin users decreased faster than that in the older subjects. Depression in female and younger heroin users improved more rapidly than in male and older subjects, respectively.

Cardiovascular effects of methadone and concomitant use of diazepam during methadone maintenance treatment induction: low concentration risk

ABSTRACTBackground: The aim is to evaluate the role of diazepam concentrations in development of low-concentration-methadone-associated QTc prolongation in patients with opioid use disorder during methadone maintenance treatment (MMT) induction.Research design and methods: Individuals with addiction disorder on MMT were studied before the beginning of MMT and after one and six months of MMT. Serum concentrations of methadone, diazepam, electrolytes and ECG were analyzed.Results: Thirty patients were enrolled. The mean methadone concentration at time points was 177 ± 119 ng/ml and 343 ± 182 ng/ml, while the mean diazepam concentration was 561 ± 437 ng/ml and 1045 ± 933 ng/ml. The QTc interval before the introduction of MMT, after 1 and 6 months of MMT were 412 ± 27 ms, 425 ± 18 ms and 424 ± 15 ms, respectively, showing statistically significant increase in the length of QTc interval after 1 and 6 months of MMT. Statistically significant correlation between the concentration of methadone and QTc interval length at observed time points (R2 = 0.239, p = 0.018; R2 = 0.513, p = 0.006) was shown, and it remained so if the concentration of diazepam was included (R2 = 0.347, p = 0.026, R2 = 0.513, p = 0.009).Conclusions: The prolongation of QTc below the risk threshold in low methadone therapeutic doses has been recorded and concomitant use of diazepam could be a co-factor in such issue.

Sexual Dysfunction among Males with Opiate Dependence Undergoing Methadone Maintenance Therapy (MMT)

Background: The aim of this study was to assess the prevalence of sexual dysfunction and to investigate whether there is a change in sexual dysfunction after six months of methadone maintenance therapy (MMT) compared with baseline. Patients and Methods: We recruited 150 male Iranian patients from several centers offering methadone maintenance therapy (MMT). Patients underwent structured interview that consisted of socio-demographic characteristics, drug use, and sexual behavior, the patients completed the International Index of Erectile Function -15 (IIEF-15) and Sexual Self-efficacy Scale - Erectile Functioning (SSES-E) tests to assess sexual dysfunction. The statistical method used for analyzing data was the Mann-Whitney U test. Results: Among men on MMT, 65 had erectile dysfunction (ED). The baseline mean score on the IIEF was 15.55 and, after taking methadone, that positively increased to 18.12 in the post-assessment. Analysis indicated significant improvement in erectile function, sexual desire, overall satisfaction, and orgasmic function after methadone maintenance treatment. Also, the baseline means score on the SSES-E was 86.71, which increased moderately to 94.34 in the post-assessment. Conclusions: Results showed that sexual dysfunction is a prevalent disorder in opioid-dependent males. Addiction withdrawal centers should be warned about the dysfunction caused by opioids and, from a clinical perspective, it is imperative that patients misusing opiates and those treated with methadone are routinely asked about their sexual functioning so that, if indicated, appropriate investigations and treatment can be planned. Further, the findings of this study revealed an improvement in some aspects of sexual dysfunction in patients after six months of methadone maintenance treatment. Thus, explaining to addicts that methadone causes fewer complications than using illegal drugs can help prevent premature exit from MMT. A¯Â?½ 2016, Zahedan University of Medical Sciences.

Role of Benzodiazepines In Cardiac Safety of Low Methadone Doses In Patients During Methadone Maintenance Treatment

Role of BeNzodiazepiNeS iN CaRdiaC SafeTy of low MeThadoNe doSeS iN paTieNTS duRiNg MeThadoNe MaiNTeNaNCe TReaTMeNT S. Petkovic ; V. Mijatovic ; I. Samojlik; S. Vukmirovic ; A. Dickov; and T. Popov Faculty of Medicine, University of Novi Sad, Vojvodina, Serbia; and Institute of Cardiovascular Diseases Vojvodina, Sremska Kamenica, Serbia Introduction: Despite the fact that most of health care professionals are aware of possible respiratory depressant effect of methadone and benzodiazepines coadministration, recently published data reveal that ventricular arrhythmia and cardiac arrest are currently the most frequent adverse event attributed to methadone and benzodiazepine comedication. The aim of this study is to assess cardiac safety of low methadone doses used concomitantely with benzodiazepines in opiate addicts in methadone maintenance treatment (MMT). Material and Methods: A clinical trial in which participated 30 opiate addicts at the start of MMT was performed. ECG (to calculate corrected QT (QTc) interval) and blood sampling (to determine methadone and diazepam concentrations ) were performed in all study participants at 3 time points (before the introduction of MMT, after 1 and 6 mo of MMT). Methadone and diazepam concentrations in serum were determined by using liquid chromatography-mass spectrometry (LC-MS). Results: The length of QTc interval before the introduction of MMT was 411.87 ± 27.22 ms, after 1 month of MMT 425.20 ± 17.71 ms and after 6 months of MMT 423.50 ± 14.72 ms. The mean methadone concentration at observed time points was 176.77 ± 118.56 ng/ mL and 342.86 ± 181.54 ng/mL, respectively, while the mean diazepam concentration was 560.74 ± 436.72 ng/mL and 1045.32 ± 932.72 ng/mL, respectively. There was a statistically significant increase in the length of QTc interval after 1 and 6 months of MMT in comparison to the value before the application of MMT. A statistically significant correlation between the concentration of methadone and QTc interval length after 1 and 6 months of MMT was observed and it remained statistically significant if concentration of diazepam was included. Conclusions: Further studies could clarify the possible role of benzodiazepines in the increasing cardiotoxicity of methadone in opiate addicts in MMT. Acknowledgement: The Ministry of Education and Science of the Republic of Serbia (grant numbered 41012) supported this research work.

Evaluation of serum adiponectin concentrations among drug abusers on methadone maintenance treatment.

Background:Adiponectin, an adipocyte-derived protein, modulates a number of metabolic processes. Methadone maintenance treatment (MMT) changes the level of hormones produced by adipose tissue in addicts. However, current data remains contradictory.Objectives:The aim of this study was to evaluate the effect of MMT on serum adiponectin levels in drug addicts.Materials and Methods:Twenty-five drug abusers with a mean age of 37.4 ± 8.7 years were referred to the Baharan Hospital, Zahedan, and 22 healthy age-matched control subjects with a mean age of 35 ± 9.5 years were enrolled in the study. Addicts were treated with methadone at (40 to 120 mg/d) for six months. Measurement of anthropometric parameters, serum adiponectin, and biochemical parameter levels, were assessed in the addicts, before and after six months of MMT, but only once in the healthy controls.Results:The mean basal serum adiponectin level was not significantly lower in the drug abuser group compared to the healthy subjects (P > 0.05). After six months of MMT, the mean serum adiponectin level of the drug addicts was not significantly different from their mean baseline level or that of the healthy subjects (P > 0.05). However, the mean baseline serum adiponectin level was significantly lower in overweight/obese addicts when compared to underweight patients and healthy individuals (P < 0.001). After six months of MMT, the mean level of serum adiponectin increased significantly in the underweight subjects compared to the normal weight and overweight/obese subjects (P < 0.0001) and the control group (P < 0.001). Adiponectin concentration was correlated inversely with body mass index and positively correlated with waist circumference and serum high-density lipoprotein levels.Conclusions:This study showed that MMT did not markedly alter the concentration of serum adiponectin in drug abusers. However, in regard to the variations in the serum lipid profiles and anthropometric parameters, the findings indicated that low concentrations of serum adiponectin might play a role in the pathogenesis of obesity and other metabolic abnormalities. Thus, more long-term studies with larger sample sizes are recommended.

Improvements in Outcomes in Methadone Patients on Probation/Parole Regardless of Counseling Early in Treatment

This secondary data analysis examined the association between criminal justice (CJ) status and outcomes over 12 months of methadone maintenance treatment. In the parent study, 230 newly admitted patients were randomly assigned to methadone either with or without counseling for 4 months followed by standard methadone with counseling. Participants completed the ASI and urine drug testing at baseline and 4- and 12-month follow-up and the Treatment Readiness (TR) scale at baseline. The relationship between baseline CJ status (whether participants were on probation or parole), CJ status by study counseling condition, and CJ status by TR with heroin and cocaine use, illegal activity, days in treatment and treatment retention, arrests, and the number of days incarcerated or hospitalized during follow-up was examined. Compared with participants not on probation/parole, probationers/parolees showed significant reductions in cocaine-positive tests from baseline to 12 months (P < 0.001). Probationers/parolees additionally reported significantly fewer days of illegal activity than nonprobationers/parolees at 12 months (P = 0.02). There was no relationship between CJ status and counseling condition for any outcomes. The relationship between CJ status and TR was significant only for cocaine-positive tests assessed over time (P = 0.017). Findings suggest that methadone participants on probation/parole showed improvements in outcomes in comparison with participants not on probation/parole, regardless of whether they received counseling during the first 4 months of treatment.

Sexual dysfunction in male crystalline heroin dependents before and after MMT: a pilot study.

Sexual dysfunction (SD) is a common problem among chronic opiate dependents. The purpose of this study is to examine the prevalence of SD and to investigate whether there is a change in SD after six months of methadone maintenance treatment (MMT) compared with baseline. We recruited 30 patients mean age 34.5 years from an MMT center in Damghan, Iran. Patients underwent structured interviews that consisted of the following: (i) socio-demographic characteristics, drug use, and sexual behavior ; (ii) the International Index of Erectile Function (IIEF-15) test for SD; (iii) the Zung test for depression; and (iv)analysis of serological status. Overall, 8% of participants reported no SD, 69% reported mild to moderate SD, and 23% reported severe SD upon admission. After completion of the MMT program, these results decreased to 61% and 20%, respectively. In comparison with admission, the mean IIEF-15 score showed moderate improvement from 16.77 ± 7.08 to 21.8 ± 6.40 (P = 0.003). The mean IIEF-15 score for intercourse satisfaction completely improved from12.20 ± 4.55to 15 ± 3.76 (P = 0.001). Slight improvements were noted in the mean IIEF-15 score for sexual desire which increased from 5.10 ± 2.28 to 6.57 ± 2.12 (P = 0.017) and the mean IIEF-15 score for overall satisfaction which increased from 5.10 ± 2.29 to 6.58 ± 2.12 (P = 0.017). However, the mean IIEF-15 score for orgasmic function very slightly decreased from 4.73 ± 4.50 to 4.57 ± 1.92 (P = 0.191), which showed no statistically significant improvement after MMT. There was no relation with depression. The findings of this study reveal a prevalence of SD and improvements in some aspects of SD in patients after six months of MMT. Patients should be screened for SD at the onset of opioid replacement treatment. Future studies on SD should examine the potential benefits of androgen replacement, hormone assay and the role of psychosocial factors.

Deep brain stimulation compared with methadone maintenance for the treatment of heroin dependence: a threshold and cost‐effectiveness analysis

To determine the success threshold at which a theoretical course of deep brain stimulation (DBS) would provide the same quality of life (QoL) and cost-effectiveness for heroin dependence as methadone maintenance treatment (MMT). We constructed a decision analysis model to calculate QoL after 6 months of MMT and compared it to a theoretical course of DBS. We also performed a cost-effectiveness analysis using societal costs of heroin dependence, MMT and DBS. Systematic literature review and meta-analysis. Patients (n = 1191) from 15 trials administering 6 months of MMT and patients (n = 2937) from 45 trials of DBS for movement disorders. Data on QoL before and after MMT, retention in MMT at 6 months, as well as complications of DBS and their impact on QoL in movement disorders. We found a QoL of 0.633 (perfect health = 1) in heroin addicts initiating MMT. Sixty-six per cent of patients completed MMT, but only 47% of them had opiate-free urine samples, resulting in an average QoL of 0.7148 (0.3574 quality-adjusted life years (QALYs) over 6 months). A trial of DBS is less expensive ($81,000) than untreated (or relapsed) heroin dependence ($100,000), but more expensive than MMT ($58,000). A theoretical course of DBS would need a success rate of 36.5% to match MMT, but a success rate of 49% to be cost-effective. The success rate, defined as the percentage of patients remaining heroin-free after 6 months of treatment, at which deep brain stimulation would be similarly cost-effective in treating opiate addiction to methadone maintenance treatment, is estimated at 49%.

No Change of Sleep After 6 and 12 Months of Methadone Maintenance Treatment

To determine whether the methadone maintenance treatment (MMT) affects sleep. We prospectively followed up the sleep pattern of 23 opiate addicts when admitted to MMT and after 6 and 12 months of treatment. Pittsburgh Sleep Quality Index, pain self-report questionnaires, urine for drug abuse, and one-night sleep polysomnography were assessed. The baseline sleep indices (sleep time [5.5 ± 1.1 hours], sleep efficiency [80.6% ± 10.5%], rapid eye movement [REM] stage percent of sleep [14.3% ± 8.4%], percent of non-REM stage 3-4 [6.7% ± 8.6%], and Pittsburgh Sleep Quality Index Scores [11.4 ± 4.8]) did not change at 6 and 12 months. Proportion of patients with absent non-REM stage 3-4 reduced (47.8%, 34.8%, 13%, P = 0.03), and mean REM density increased (P = 0.04). Body mass index increased (24 ± 4.2 kg/m, 25.7 ± 4 kg/m, 27.1 ± 4.8 kg/m, P < 0.0005) with no change in the rate of benzodiazepine abuse or chronic pain. No patient had central sleep apnea. The Respiratory Disturbance Index (apnea or hypopnea numbers/sleep hr) increased among 5 patients who increased ≥25% of their entry weight (3.4 ± 4.1, 11.8 ± 10.1, 29.6 ± 30.4 Respiratory Disturbance Index's) but not with the other 18 (3.9 ± 4.8, 6.2 ± 6.2, 7.8 ± 7.4). We conclude that MMT did not negatively affect the opiate addicts' baseline poor perceived and objective sleep. Only extensive weight gain (evident in a minority of patients) was associated with obstructive sleep apnea.

Alcohol use problem among patients in methadone maintenance treatment in Taiwan

Aims To examine the prevalence rate and predictors of alcohol use problems among patients undergoing methadone maintenance treatment (MMT). Design This was a prospective follow-up study. Participants Study population included 438 patients who underwent more than 6 months of MMT. Measurements Demographic and clinical characteristics were collected for each patient prior to treatment, and treatment-related variables were collected during treatment process. Hazardous drinking, alcohol abuse, and dependence were measured using a Chinese version of the Alcohol Use Disorders Identification Test (AUDIT) and by measuring breath alcohol concentration. Findings The prevalence rates of alcohol use problems, indicated by hazardous drinking are 31.4%. The protective predictors of alcohol use problems among MMT patients include an attendance rate of more than 90% (odds ratio [OR] = 0.54, 95% confidence interval [CI] = 0.30–0.97) and being older than 36 years (OR = 0.48, 95% CI = 0.27–0.86), and alcohol drinking problem at intake of study is a risk factor (OR = 5.30, 95% CI = 2.87–9.76). Conclusions High attendance rate, which is regarded as a component of clinical policy and a key component of therapeutic context, should be incorporated with brief interventions to lower alcohol use problems among MMT patients.

Monthly Take-Home Methadone Maintenance Regime for Elderly Opium-Dependent Users in Singapore

Research suggests that methadone maintenance treatment (MMT) effectively reduces opiate dependence and related health and social problems. However, few studies have examined its effectiveness among the elderly. This study examined a monthly MMT regime for elderly opium addicts attending the National Addictions Management Service, Singapore. This study used a cross-sectional design and comprised 40 patients attending the addiction service and 40 caregivers who monitored methadone consumption (mostly patients' sons and daughters). Participants completed a semi-structured interview comprising measures of opiate craving and withdrawal, physical and psychological health. Objective measures were urine drug screens and blood tests. Participants who averaged 74.8 years old had been using opium for around 44 years and had been in MMT for an average of 35 months. The maintenance dose of methadone was 9.2 mg/day. At interview, no opiate usage (other than methadone) was detected in urine screens; however, clinical records indicated that 6 had tested positive during the previous 6 months of MMT. No major withdrawal symptoms, side effects, or incidents of diversion were reported. Quality-of-life scores were in the normal range and satisfaction with the treatment regime was expressed by caregivers. Whilst MMT is the predominant pharmacotherapy for opiate dependence for users of all ages elsewhere, our study group constitutes a unique population that differs markedly from younger opiate users who will eventually grow old. In Singapore, MMT appears to be an effective treatment for stable, elderly opium-dependent patients where families are fully engaged in the treatment regime.

Cognitive function in short- and long-term substitution treatment: Are there differences?

Cognitive impairment in drug-dependent patients receiving methadone maintenance treatment has been reported previously, although the literature is limited and results remain controversial. Long-term effects under stable methadone maintenance treatment (MMT) and the possibility of improvement in cognitive performance during long-term substitution treatment have rarely been investigated. We performed a comparative study investigating differences in cognitive functions under short- and long-term methadone treatment to test the hypothesis that patients perform better under long- than under short-term MMT. Seventy-seven patients were assessed cross-sectional either at least 30 days after the start of MMT (short-term group, n=35) or after at least 6 months of MMT (long-term group, n=42) with a comprehensive neuropsychological test battery on intelligence, learning and memory, attention and executive functions. Urine screenings were performed immediately before neuropsychological testing to check for concomitant drug use. Our findings may suggest, with all due caution, a slightly better performance of the long-term group in executive functions and visuo-construction. No group differences were found in attentional functions and learning and memory. More longitudinal research and studies controlling for the effects of dosage and duration of opioid addiction are necessary to examine whether cognitive ability may improve under long-term MMT.

Study on the time of retention and related influencing factors of patients receiving methadone maintenance treatment in Hunan province

to explore the current situation and related influencing factors on the retention time of patients receiving methadone maintenance treatment (MMT). Information on basic situation and daily treatment of the patients were collected from the 7 MMT clinics opened in the pro-two batch in Hunan province. Retention rate and influencing factors were analyzed. (1) The retention rates after 6 and 12 months of MMT became 72.06% and 49.65% respectively. (2) The retention rates of high-dosage group and low-dosage group were 85.03% and 68.03% after 6 months on MMT program while became 60.48% and 46.28% after 12 months of MMT respectively. (3) The mean retention time of HIV+ patients and HIV patients were 9.46 months and 8.62 months respectively during the 12 months follow-up observation, showing a significant difference. (4) Patients who took large dose methadone, did not share needles, at older age or HIV+, were prone to keep MMT at a long period. The retention rates for 6 months and 12 months in the MMT program in Hunan province were similar to the national data. Dose, type of drug abuse, age and HIV status were related to the period of retention.

Cognitive function in short- and long-term substitution treatment: Are there differences?

Cognitive impairment in drug-dependent patients receiving methadone maintenance treatment has been reported previously, although the literature is limited and results remain controversial. Long-term effects under stable methadone maintenance treatment (MMT) and the possibility of improvement in cognitive performance during long-term substitution treatment have rarely been investigated. We performed a comparative study investigating differences in cognitive functions under short- and long-term methadone treatment to test the hypothesis that patients perform better under long- than under short-term MMT. Seventy-seven patients were assessed cross-sectional either at least 30 days after the start of MMT (short-term group, n=35) or after at least 6 months of MMT (long-term group, n=42) with a comprehensive neuropsychological test battery on intelligence, learning and memory, attention and executive functions. Urine screenings were performed immediately before neuropsychological testing to check for concomitant drug use. Our findings may suggest, with all due caution, a slightly better performance of the long-term group in executive functions and visuo-construction. No group differences were found in attentional functions and learning and memory. More longitudinal research and studies controlling for the effects of dosage and duration of opioid addiction are necessary to examine whether cognitive ability may improve under long-term MMT.

The Effect of Methadone Maintenance on Illicit Opioid Use, Human Immunodeficiency Virus and Hepatitis C Virus Infection, Health Status, Employment, and Criminal Activity Among Heroin Abusers During 6 Months of Treatment in China

: This study was designed to evaluate the effects of methadone maintenance treatment (MMT) on severity of dependence, depression, human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection, health status, employment, and criminal activity among heroin abusers after 3 and 6 months of treatment, compared with baseline, in China. : A total of 102 methadone maintenance treatment (MMT) patients (87 men and 15 women; mean age, 36.1 years; standard deviation = 6.9) without major medical or psychiatric comorbidity participated in the experimental procedure. They were given oral methadone (maximum daily dose 80 mg, minimum daily dose 30 mg). Opioid use was assessed by twice-weekly urinalysis; HIV and HCV status were assessed by standard blood tests. Questionnaires were administered to assess blood-borne-virus risk behavior, severity of dependence, depression, health status, employment, and criminal activity. Changes over time were evaluated by 1-way analysis of variance (ANOVA) followed by post hoc t tests. : Opioid use was reduced from 26.7 days per month at baseline to 0.7 and 0.0 days at 3 and 6 months, respectively. No participant seroconverted to HIV and HCV positivity during the 6 months of MMT. Health status significantly improved, as did severity of dependence, depression, and criminal activity, after 3 and 6 months MMT. : The results support the broad beneficial effects of MMT in China.

Outpatient methadone maintenance treatment program Quality of life and health of opioid-dependent persons in Lithuania

The evaluation of quality of life and self-perceived health represents an assessment of the impact of treatment on patient functioning and well-being. Our aim was to explore the impact of methadone maintenance treatment on quality of life and self-perceived health of opioid-dependent persons in Lithuania. A total of 102 opioid-dependent patients were recruited in the study. A prospective follow-up study design was used. To assess quality of life, the WHOQOL-BREF 26-item version was used. The impact of methadone maintenance treatment on self-perceived health was assessed by Opiate Treatment Index (OTI). Following 6 months of methadone maintenance treatment, significant improvements in physical (P=0.004), psychological (P=0.004), and environmental (P=0.048) components of quality of life were observed; no statistically significant improvements were found in social component of quality of life. Study participants reported lower rates of medical morbidity associated with injection (P<0.001), cardiorespiratory (P=0.034), musculoskeletal (P<0.001), neurological (P=0.013), gastrointestinal (P<0.001), and general health (P<0.001). Methadone maintenance treatment substantially reduces morbidity associated with opioid dependence and improves the quality of life of patients.