Methadone & Methadone Addiction

Opiates and poppy seed products

Mon, 25 Feb 2008 05:31:36 GMT

Opiate concentrations following the ingestion of poppy seed products - evidence for 'the poppy seed defence'

The Substance Abuse and Mental Health Services Administration1 stipulated 300 ng/ml cut-off limit for opiate assays has been called into question due to positive results being obtained following the ingestion of poppy seed containing food products.

To establish the plausibility of "the poppy seed defence" the concentrations of codeine, norcodeine, morphine, normorphine and thebaine (a potential marker for seed ingestion) in several varieties of seeds were quantified by GC-MS. The maximum morphine and codeine concentrations were found to be 33.2 and 13.7 m g/g seed respectively. The country of origin of the seed specimen and the preparation of the seeds before their use was found to influence the alkaloid concentration determined.

All urine specimens analysed following the consumption of bread rolls (mean 0.76 g seed per roll) by four subjects produced negative results in the EMIT opiate assay with the exception of one subject (body weight 63.0 kg) who consumed two poppy seed rolls. In this subject opiate positive screening results (Behring EMIT II opiate assay) were obtained for up to 4 - 6 h post ingestion with maximum urinary morphine and codeine concentrations of 832.0 ng/ml (@ 2 - 4 h post ingestion) and 47.9 ng/ml (@ 0 - 2 h post ingestion) respectively being achieved.

Following the ingestion of poppy seed cake (mean 4.69 g seed per slice) by four individuals opiate positive screening results were obtained for up to 12 - 24 h. In one subject (dose equivalent to 0.07 g poppy seed/kg body weight) maximum urinary morphine and codeine concentrations of 302.1 ng/ml (@ 0 - 2 h) and 83.8 ng/ml (@ 2 - 4 h) respectively were recorded.

These findings demonstrate the plausibility of the poppy seed defence. Great care should therefore be taken when interpreting the data produced from drugs of abuse screening for opiates.

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Before taking methadone

Wed, 30 Jan 2008 02:52:15 GMT

tell your doctor and pharmacist if you are allergic to methadone or any other medications.
tell your doctor and pharmacist what prescription and nonprescription medications, vitamins, and nutritional supplements you are taking or plan to take. Be sure to mention any of the following: antidepressants such as amitriptyline (Elavil), amoxapine (Asendin), clomipramine (Anafranil), desipramine (Norpramin), doxepin (Adapin, Sinequan), imipramine (Tofranil), nortriptyline (Aventyl, Pamelor), protriptyline (Vivactil), and trimipramine (Surmontil); certain antifungals such as fluconazole (Diflucan), itraconazole (Sporanox), ketoconazole (Nizoral), and voriconazole (Vfend); antihistamines; buprenorphine (Subutex); butorphanol (Stadol NS); calcium channel blocking agents such as amlodipine (Norvasc), diltiazem (Cardizem, Dilacor, Tiazac, others), felodipine (Plendil), isradipine (DynaCirc), nicardipine (Cardene), nifedipine (Adalat, Procardia), nimodipine (Nimotop), nisoldipine (Sular), and verapamil (Calan, Covera, Isoptin, Verelan); diuretics ('water pills'); erythromycin (E.E.S., E-Mycin, Erythrocin); laxatives; medications for anxiety, mental illness, nausea, or pain; medications for HIV including abacavir (Ziagen), amprenavir (Agenerase), didanosine (Videx), efavirenz (Sustiva), lopinavir (in Kaletra), nelfinavir (Viracept), nevirapine (Viramune), ritonavir (Norvir, in Kaletra), stavudine (Zerit), and zidovudine (Retrovir);certain medications for irregular heartbeat such as disopyramide (Norpace), flecainide (Tambocor), mexiletine (Mexitil), moricizine (Ethmozine), procainamide (Procanbid, Pronestyl), propafenone (Rythmol), propranolol (Inderal), quinidine (Quinidex), and tocainide (Tonocard); certain medications for seizures such as carbamazepine (Carbatrol, Epitol, Tegretol),phenytoin (Dilantin, Phenytek); phenobarbital nalbuphine (Nubain); naloxone (Narcan);naltrexone (ReVia, Depade); pentazocine (Talwin); rifampin (Rifadin, Rimactane, in Rifamate); risperidone (Risperdal); sedatives; certain selective serotonin reuptake inhibitors (SSRIs) such as fluvoxamine (Luvox) and sertraline (Zoloft); sleeping pills; certain steroids such as cortisone, fludricortisone (Flurinef), and hydrocortisone (Cortef); and tranquilizers. Also tell your doctor or pharmacist if you are taking the following medications or have stopped taking them in the past 14 days: monoamine oxidase (MAO) inhibitors including isocarboxazid (Marplan), phenelzine (Nardil), selegiline (Eldepryl, Emsam, Zelpar), and tranylcypromine (Parnate). Many other medications may also interact with methadone, so be sure to tell your doctor about all the medications you are taking, even those that do not appear on this list. Your doctor may need to change the doses of your medications or monitor you carefully for side effects.
tell your doctor what herbal products you are taking, especially St. John's wort.
tell your doctor if you have or have ever had asthma or other breathing problems or a blockage in your intestine. Your doctor may tell you that you should not take methadone.
tell your doctor if you have or have ever had a head injury, a brain tumor, a stroke, or any other condition that caused high pressure inside your skull; irregular heartbeat; urethral stricture (narrowing of the tube that carries urine out of the body), enlarged prostate (a male reproductive gland), or any other condition that causes difficulty urinating; Addison's disease (a condition in which the body does not make enough of certain natural substances); mental illness; chronic obstructive pulmonary disease (COPD; a group of lung diseases); kyphoscoliosis (condition in which the spine curves abnormally); sleep apnea (condition in which breathing stops for short periods during sleep); low levels of potassium or magnesium in your blood; or thyroid , heart, liver, or kidney disease. Also tell your doctor if you drink or have ever drunk large amounts of alcohol or if you use or have ever used street drugs or have overused prescription medications.
tell your doctor if you are pregnant, plan to become pregnant, or are breast-feeding. If you become pregnant while taking methadone, call your doctor.
if you are having surgery, including dental surgery, tell the doctor or dentist that you are taking methadone.
you should know that this medication may make you drowsy. Do not drive a car or operate machinery until you know how this medication affects you.
remember that alcohol can add to the drowsiness caused by this medication.
tell your doctor if you use tobacco products. Cigarette smoking may decrease the effectiveness of this medication.
you should know that methadone may cause dizziness when you get up too quickly from a lying position. This is more common when you first start taking methadone. To avoid this problem, get out of bed slowly, resting your feet on the floor for a few minutes before standing up.

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What side effects can this medication cause?

Wed, 30 Jan 2008 02:47:31 GMT

Methadone may cause side effects. Tell your doctor if any of these symptoms are severe or do not go away:

drowsiness
weakness
headache
nausea
vomiting
constipation
loss of appetite
weight gain
stomach pain
dry mouth
sweating
flushing
difficulty urinating
swelling of the hands, arms, feet, and legs
mood changes
vision problems
difficulty falling asleep or staying asleep
decreased sexual desire or ability
missed menstrual periods

Some side effects can be serious. If you experience any of the following symptoms or those mentioned in the IMPORTANT WARNING section, call your doctor immediately:

seizures
itching
hives
rash

Methadone may cause other side effects. Call your doctor if you have any unusual problems while you are taking this medication.

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Methadone Abuse: Fastest-Growing Drug Problem

Wed, 30 Jan 2008 02:34:44 GMT

Initially developed as a drug to treat patients suffering from the often extreme elements of opiate withdrawal, methadone has become one of the most widely abused drugs in the world, with related casualties more than quadrupling over the last five years in the United States alone. Methadone is a lab-produced synthetic opiate created by German researchers in the 1930's as an analgesic, and its best-known rehabilitative function is to regulate the body's supply of dopamine, a pleasure-inducing neurotransmitter. Heroin and other opiates attach themselves to dopamine-regulating neurons, thereby allowing huge amounts of the chemical to flood the body directly after consumption. Its production glands exhausted, dopamine then leaves the system very quickly, and its subsequent shortage in the bodies of withdrawing addicts creates the daily cravings that feed physical and psychological dependence. While on methadone, addicts do not receive the same highs from their substance of choice because it blocks the large-scale release of dopamine; it also does not provide the physical euphoria associated with heroin, and one might assume that its users do not stand as great a risk of developing addictions. But the substance can work as a very effective sedative, and it builds in the body's fatty tissue and maintains its presence much longer than any related drugs, so users may underestimate of the increased chances of overdose if they've been on the drug for some time and carry large quantities of it in their systems.

More than 100,000 American drug users (or an estimated 20% of opiate addicts) receive methadone treatment each day, and the substance has unquestionably made significant progress in counteracting the abuse of heroin as well as extremely dangerous synthetic painkillers like OxyContin and Vicodin. Experts warn that the increasing prevalence of the drug, its relative affordability, and the ease with which general practitioners can prescribe it for problems unrelated to drug abuse have all contributed to this growing problem - almost four thousand Americans died of methadone overdose in 2005, an exponential increase from the less than 800 killed by the drug in 1999. Recent highly-publicized deaths in which methadone played at least a supporting role have directed public attention toward this very real problem. The majority of these deaths occur among patients who have been prescribed the drug for pain resulting from serious injury or disease, and doctors have increasingly chosen to give the drug to patients while drug enforcement officials focus on more immediately damaging opiates.

Because of its relatively low cost and availability, an increasing number of street users now buy black marketed methadone as an easier alternative to heroin or OxyContin. While it doesn't provide the same sort of high, it does provide much-needed symptomatic relief. Some take advantage of this situation by selling prescribed methadone at a significantly marked-up price. Casual users may view the drug as a safe buzz, but when used in combination with other conflicting prescriptions or intoxicants like alcohol and barbiturates, it can have dramatic and potentially fatal consequences. The drug's effects are also delayed, so users may increase their dosages while looking for a high and unwittingly suffer from heart failure as the substance builds up in the system. Though methadone is unquestionably a useful and potentially life-saving medication, and many continue to emphasize its positive properties, recent statistics are anything but encouraging. Increased regulation and public awareness seem to be the most obvious solutions to the growing epidemic stemming from the misuse and abuse of methadone. Unfortunately, more public tragedies are likely to unfold before the general populace wakes up to the dangers of this powerful drug.

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Methadone Poisoning Has Increased at Alarming Rate

Wed, 30 Jan 2008 00:25:50 GMT

Deaths related to methadone use — a drug used to treat heroin addiction — are skyrocketing, a Justice Department report found. The drug can be safely used as part of treatment, but has serious health repercussions when mixed with other drugs and alcohol. (ABC News)

Deaths from methadone, a drug used in the treatment of heroin addiction, have risen at an alarming rate in recent years, according to a Justice Department assessment.

As part of treatment, methadone has been used successfully since the 1950s. While it is safe to use when closely monitored under a physician's care, methadone can be deadly when abused by addicts who often take the drug with other drugs and alcohol.

The assessment from the National Drug Intelligence Center found that methadone poisoning increased 390 percent from 1999 to 2004. This accounted for a jump from 786 deaths in 1999 to 3,849 deaths in 2004.

According to the report, "Selected state health department data indicate methadone poisoning deaths increased through 2006."

During the 1999 to 2004 time period, cocaine-related deaths also increased 43 percent, from 3,822 to 5,461.

Theft and division of the drug in recent years have increased, with the report finding that 18,547 doses were stolen in 2004. The number of stolen doses dramatically increased to 67,867 in 2006.

According to the DEA, in 2001 the number of medical practitioners who could distribute methadone was only 6,260, increasing more than 700 percent to 51,046 medical practitioners able to prescribe the drug.

The report noted that the increase in abuse of the pain reliever OxyContin has led to more doctors prescribing methadone. "Many practitioners began to dispense methadone as a pain reliever, following the negative publicity surrounding OxyContin's high potential for addiction and abuse," it said.

The FDA issued a public health advisory about methadone in November 2006, which noted that part of the problem of methadone overdoses occurred because the drug remains in the body for anywhere from 8 to 59 hours.

The advisory stated, "Methadone may build up in the body to a toxic level if it is taken too often, if the amount taken is too high, or it is taken with certain other medications or supplements."

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