Document Detail


Exploring the relationship between perceived inter-dose opioid withdrawal and patient characteristics in methadone maintenance treatment.
MedLine Citation:
PMID:  19713051     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Despite clinical optimization of methadone doses, as many as 53% of patients experience significant and unacceptable levels inter-dose opioid withdrawal some of the time. Little is known about the relationship between perceived inter-dose opioid withdrawal and patient characteristics in methadone maintenance treatment. METHODS: Ninety stabilized MMT patients were recruited and divided into three satisfaction groups (holders (H), partial holders (PH), and nonholders (NH)) based on their perceived opioid withdrawal as assessed by a guided self-report process. A battery of subjective assessments was administered during the approximate trough methadone condition. The primary measures were the Subjective Opioid Withdrawal Scale (SubOWS), Hopkins Symptom Checklist-90 (SCL-90), Obsessive-Compulsive Drug Use Survey (OCDUS), Profile of Mood States (POMS), and Neo Personality Inventory (NEO). RESULTS: Nonholders experienced more opioid withdrawal (SubOWS-NH: 22.0+/-8.8 vs. PH: 12.2+/-8.2 vs. H: 9.3+/-10.0, p<0.001) and craving (OCDUS-NH: 11.4+/-8.8 vs. PH: 6.4+/-6.9 vs. H: 6.5+/-6.2, p=0.016). Holders experienced less Obsessive/Compulsive psychological distress (SCL-90-NH: 15.3+/-8.1 vs. PH: 12.3+/-7.3 vs. H: 6.6+/-5.1, p<0.001), Depression/Dejection (POMS-NH: 19.7+/-13.7 vs. PH: 17.2+/-13.2 vs. H: 7.9+/-10.4, p=0.002), and neurotic personality (NEO-NH: 63.3+/-12.3 vs. PH: 60.9+/-10.0 vs. H: 54.0+/-8.8, p=0.006). Partial holders had a less agreeable personality (NEO-NH: 44.2+/-8.6 vs. PH: 38.0+/-10.6 vs. H: 47.6+/-11.7, p=0.002). CONCLUSIONS: Physical opioid withdrawal is an important factor in understanding patient satisfaction with MMT. However, patient characteristics, such as level of psychological distress and negative mood, may also need to be considered because of their relationship with perceived inter-dose opioid withdrawal symptoms and patient satisfaction.
Authors:
Alex K Elkader; Bruna Brands; Russell Callaghan; Beth A Sproule
Publication Detail:
Type:  Comparative Study; Journal Article     Date:  2009-08-26
Journal Detail:
Title:  Drug and alcohol dependence     Volume:  105     ISSN:  1879-0046     ISO Abbreviation:  Drug Alcohol Depend     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7513587     Medline TA:  Drug Alcohol Depend     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  209-14     Citation Subset:  IM    
Affiliation:
Centre for Addiction and Mental Health, 33 Russell St., Toronto, ON, Canada M5S 2S1.
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MeSH Terms
Descriptor/Qualifier:
Adult
Affect
Anxiety
Behavior, Addictive / psychology
Female
Humans
Male
Methadone / therapeutic use
Opioid-Related Disorders / drug therapy,  psychology*
Pain / psychology
Patient Satisfaction
Personality
Stress, Psychological
Substance Withdrawal Syndrome / diagnosis,  psychology*
Time Factors
Chemical
Reg. No./Substance:
76-99-3/Methadone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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