Document Detail


Methadone induction doses: are our current practices safe?
MedLine Citation:
PMID:  16956864     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To review the literature on methadone deaths and propose evidence-based dosing guidelines. METHODS: A literature search was conducted on overdose deaths during the induction phase. Data on methadone deaths from the Ontario coroner's office, as well as prescribing guidelines from different countries and jurisdictions, were reviewed. The information was collectively considered and, using the best available evidence, translated into safe dosing guidelines for methadone induction. RESULTS: A literature review found high death rates during the methadone induction period. Data from the Ontario coroner's office revealed that of deaths that were felt to be attributable to methadone overdose, the majority occurred in those who had consumed diverted methadone: of those deaths within a registered program, the majority occurred during the initial dosing phase. Despite high death rates during induction onto methadone treatment, many jurisdictions do not have prescribing guidelines that take this evidence into account. CONCLUSIONS: Safer prescribing guidelines are needed to reduce deaths during induction onto methadone treatment. Recommendations are made for safe methadone induction doses.
Authors:
Anita Srivastava; Meldon Kahan
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of addictive diseases     Volume:  25     ISSN:  1055-0887     ISO Abbreviation:  J Addict Dis     Publication Date:  2006  
Date Detail:
Created Date:  2006-09-07     Completed Date:  2007-02-07     Revised Date:  2008-05-12    
Medline Journal Info:
Nlm Unique ID:  9107051     Medline TA:  J Addict Dis     Country:  United States    
Other Details:
Languages:  eng     Pagination:  5-13     Citation Subset:  IM    
Affiliation:
Centre for Addiction and Mental Health, Department of Family and Community Medicine, University of Toronto, ON, M5S 2S1, Canada.
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Drug Administration Schedule
Drug Interactions
Drug Monitoring
Drug Toxicity*
Guidelines as Topic / standards*
Heroin Dependence / mortality,  rehabilitation*
Humans
Methadone / administration & dosage*,  therapeutic use
Narcotics / administration & dosage*,  therapeutic use
Patient Education as Topic
Risk Factors
Chemical
Reg. No./Substance:
0/Narcotics; 76-99-3/Methadone
Comments/Corrections
Comment In:
J Addict Dis. 2006;25(3):1-3   [PMID:  16956863 ]

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


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