RELUCTANCE TO PROVIDE DIVIDED DOSES METHADONE:
(Am J Psych 165:10. Oct 2008) While recognizing that some patients require divided doses of methadone for optimal therapeutic outcome, a physician writes that "...the most compelling obstacle in employing this strategy relates to an increase in methadone deaths in various regions of the US." It seems folks just can't accept the clear and compelling finding of a nationwide expert panel convened by SAMHSA: "methadone from clinics is not the culprit" responsible for the increase in deaths attributed to methadone in recent years (SAMHSA News, vol. 12, no. 2, 2004). Meanwhile, how many methadone maintenance patients will drop out, how many will relapse and how many will die because they are all judged likely to divert their medication and thus denied the dosage regimen that might be optimal?
posted by RGNewman, MD @ 2:51 PM
6 comments
6 Comments:
Absolutely right, Bob. Not only are clinics unwilling to remain open long enough for new patients who may need divided doses to return for a second dose later in the day, but they are using faulty logic in denying split doses to longer term patients as well. Denial of the facts is obvious here.
Fact is there is more to the liabilty of clinical use then some care to realize or acknowledge. Current research and behavior is showing that use of methadone is not as effective as claimed. A new monster has been unleashed in this country and corrupt clinics seeking financial gain have ruined a once thought to be good idea. European studies which seem to be far advanced from American practices are showing methadone is not working, unless you call keeping people addicted "treatment". They are noe using heroin to detoc the heroin addicts and the success rate is great and very short term for the patient versus all the excuses being used with methadone. Treatment is not so much to satisfy the addict but to help them beat their addiction. Now people are wanting a divided dose? How about drive throughs just in case they get a craving in the middle of the night, please enough is enough.
MAMA.Org
Definitely you have done a perfect job. death may increase because of consuming more alcohol physicians is responsible for their patience.
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Brook
Drug Rehabilitation Programs
Unfortunately, the hostility to methadone treatment of opiate addiction seems impervious to the facts. Heroin in Europe (and elsewhere - e.g., Canada) has not been used in to detoxify addicts, but rather to maintain them. The studies have relied entirely - entirely - on comparing heroin to methadone among individuals (a small minority of patients) who have repeatedly failed to respond well to methadone maintenance. And finally, the medical and the social rationale for methadone (and more recently buprenorphine) maintenance has never been to "satisfy the addict" but rather to help her/him to achieve the desire for a reasonably healthy, self-fulfilling, socially productive life. Even for someone embroiled in the debate for 40 years it's truly mind-boggling to think that critics believe leaving heroin-dependent individuals who want and need help on the streets to shoot dope is better than engaging them in a treatment relationship - whether that treatment does or does not include the prescribing of a medication.
YA you done great job.It so harmful to our body heavy use of drugs. We will lose our antibody rejection powers.
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Sara
Drug Rehab
Until methadone is treated like any other medication which is prescribed but has a potential to be abused our country health will be held hostage by the fearmongers, ignorant folks, and moralistic condemners. Addiction, to coffee, tobacco, or methadone need not detract from people's lives -- why doesn't everyone see this as a major positive change?
Removing the profit motive from institutions to limit treatment by allowing all physicians to prescribe methadone for addiction as they are competent will unleash one of the cheapest and most effective medicines to work its magic on societies ills of opiate addiction. Society and all individuals within it will suffer less harm and science will have won out over fear and other lessor policy motivators. In other words, our society will have matured...
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