| Methadone death, dosage and torsade de pointes: risk-benefit policy implications. | |
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MedLine Citation:
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PMID: 17373567 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Methadone maintenance treatment (MMT) for opioid dependency has consistently shown important heath, social and legal benefits. What started as a small experimental program in Lexington, Kentucky has grown and expanded substantially over 35 years. Its practice is now well established both in specialized centers and in the broader community. In society, methadone deaths represent an important issue of public safety: methadone diversion to and ingestion by nontolerant individuals outside of treatment. Within treatment, methadone deaths occur most commonly in the early stabilization period (due to issue of tolerance), in periods of transition, or among certain individuals who abuse other substances (opioids, benzodiazepines, or alcohol). Research suggests moderately high methadone dosages help improve patient retention. Results from pharmacodynamic, kinetic and stereospecific studies continue to support the importance of individualizing dose. For some patients, much larger doses may be necessary to fully achieve all pharmacotherapy goals of treatment. Practitioners must be cautious however as certain patients on higher dosages are predisposed to torsade de pointes and increased mortality. Policymakers have a responsibility in their decision-making to balance the quality of life benefits for patients within MMT with the risks of increased mortality both for individuals within treatment and the general public. |
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Authors:
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Mark Latowsky |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Journal of psychoactive drugs Volume: 38 ISSN: 0279-1072 ISO Abbreviation: J Psychoactive Drugs Publication Date: 2006 Dec |
Date Detail:
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Created Date: 2007-03-21 Completed Date: 2007-04-11 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8113536 Medline TA: J Psychoactive Drugs Country: United States |
Other Details:
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Languages: eng Pagination: 513-9 Citation Subset: IM |
Affiliation:
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Department of Family and Community Medicine, University of Toronto, Toronto, Canada. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Electrocardiography
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drug effects Humans Methadone / administration & dosage, adverse effects* Opioid-Related Disorders / rehabilitation* Risk Torsades de Pointes / chemically induced* |
| Chemical | |
Reg. No./Substance:
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76-99-3/Methadone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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