Effects of methadone: A Synthesis of Findings from 10 Studies

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Original Abstract of the Article

Major Research Findings

Previous research has suggested that methadone may be more euphoric than other morphine-like drugs, but a study ( 2 ) comparing intravenous administration of methadone, morphine, and heroin in non-dependent former addicts found no significant differences in their morphine-like physiological, subjective, and behavioral effects. The only distinction between the three compounds was the duration of miosis, which was longer lasting after methadone.

Another study ( 5 ) examined the acute-on-chronic effects of methadone in patients receiving long-term methadone substitution treatment. It found that increasing the daily dose of methadone significantly increased both positive and negative cravings for heroin. This study also found that patients were unable to distinguish between methadone and placebo treatments.

A meta-analysis of methadone maintenance treatment for opioid dependence ( 7 ) concluded that methadone maintenance treatment shows positive effects on retention, opioid abuse, and criminality compared to non-active controlled conditions.

A study ( 3 ) examining the effects of contingent versus non-contingent delivery of methadone dose supplements during outpatient detoxification found that the contingent group (those who received supplements only if their urine tests were opiate-negative) had significantly lower opiate-positive urine tests and better treatment retention.

Research on the interaction of methadone and nicotine in methadone maintenance treatment patients ( 8 ) showed that cigarette smoking enhanced the effect of methadone in reducing opioid withdrawal symptoms. Both methadone and nicotine decreased nicotine withdrawal scores, and both drugs increased ratings of euphoria and drug liking while reducing restlessness, irritability, and depression.

A study ( 9 ) examined the effects of a single 50% extra dose of methadone on heroin craving and mood in lower-versus higher-dose methadone patients. This study found that the extra dose did not significantly affect heroin craving but did improve mood, with marginally greater effects in lower-dose patients.

Research on the effects of contingent methadone take-home doses on adjunct therapy attendance ( 4 ) found that take-home doses can reinforce adjunct therapy attendance in methadone maintenance patients. Patients were more likely to attend therapy sessions when they could earn take-home doses as a reward.

A study on withdrawal from methadone maintenance ( 1 ) found that withdrawal should be carried out gradually at a rate of approximately 3% of the initial dose per week. The study also emphasized the importance of preparing patients for withdrawal to reduce the effects of expectation.

A study examining the effectiveness of different methadone doses in suppressing heroin self-administration ( 6 ) found that methadone doses of 100 mg or greater were more effective than lower doses at suppressing heroin self-administration.

A study on switching from methadone to diamorphine maintenance treatment ( 10 ) found that patients who switched from methadone to diamorphine showed significant improvements in health and drug use after one year of diamorphine treatment.

Benefits and Risks

Benefits Summary

Methadone maintenance treatment can offer various benefits for individuals struggling with opioid dependence, including:

  • Increased treatment retention
  • Suppression of illicit opioid use
  • Reduction in crime rates
  • Improved health outcomes
  • Improved mood
  • Increased engagement in adjunct therapy

Risks Summary

Methadone maintenance treatment may also carry some risks, such as:

  • Increased cravings for heroin
  • Increased cravings for nicotine
  • Withdrawal symptoms
  • Development of dependence on methadone

Comparison of Studies

Commonalities of Studies

These studies generally suggest that methadone can be an effective treatment option for opioid dependence. In particular, methadone appears to be effective in reducing illicit opioid use and improving treatment retention.

Differences of Studies

The studies differ in several aspects, including research design, participant characteristics, and assessment measures. These differences can make it challenging to directly compare the results of the studies. For instance, 2 used non-dependent former addicts, while 5 focused on chronic opioid dependent patients, making direct comparison of their results difficult.

Consistency and Contradictions of Findings

While these studies point to the potential effectiveness of methadone for opioid dependence, more research is needed to reach definitive conclusions about its effects. Specifically, the influence of methadone on heroin cravings is not entirely consistent. While 5 suggests methadone might increase heroin cravings, 9 found no significant effect on heroin craving with an increased methadone dose. This suggests that methadone's impact may vary between individuals, necessitating further research to clarify this aspect.

Implications for Real-Life Application

Methadone maintenance treatment can be an effective treatment option for opioid dependence, but it is not suitable for everyone. Before starting methadone maintenance treatment, individuals should consult with a healthcare professional to discuss the risks and benefits of treatment. Combining methadone maintenance treatment with other therapeutic approaches, such as psychotherapy, may be more effective.

Limitations of Current Research

These studies have several limitations, including:

  • Small sample sizes
  • Variations in participant characteristics
  • Different research designs
  • Varied assessment measures

Future Directions for Research

Further research is needed to gain a more comprehensive understanding of methadone maintenance treatment's effects, including:

  • Investigating individual differences in response to methadone
  • Assessing the long-term effects of methadone maintenance treatment
  • Evaluating the effectiveness of combining methadone maintenance treatment with other treatment approaches
  • Further confirming the safety and efficacy of methadone maintenance treatment

Conclusion

Methadone maintenance treatment is a potentially effective option for individuals struggling with opioid dependence, but it's not a universal solution. Before starting methadone maintenance treatment, it is crucial to consult with a healthcare professional and understand the risks and benefits. Combining it with other therapies, such as psychotherapy, can enhance its effectiveness. To achieve a more comprehensive understanding of methadone maintenance treatment's effects, continued research is necessary.

Literature analysis of 10 papers
Positive Content
9
Neutral Content
0
Negative Content
1
Article Type
9
1
0
0
10
1.

Withdrawal from methadone maintenance. Rate of withdrawal and expectation.

Author: SenayE C, DorusW, GoldbergF, ThorntonW

Methadone withdrawal

Methadone withdrawal in patients successfully maintained on methadone hydrochloride was more effective when conducted at a rate of 3% of the initial dose per week compared to 10%. This approach resulted in lower dropout rates, less illicit drug use, fewer symptoms, and fewer requests for study interruption.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, Non-P.H.S.Research funding provided by US government agencies other than the Public Health Service.

Language : English

2.

Comparison of intravenously administered methadone, morphine and heroin.

Author: JasinskiD R, PrestonK L

Opiate-like effects
None mentioned

Methadone was not more potent in producing euphoria relative to its other opiate-like effects in non-dependent post-addict volunteers. The study found that methadone produced a profile of effects that was indistinguishable from that of morphine and heroin.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

3.

Contingent methadone delivery: effects on illicit-opiate use.

Author: HigginsS T, StitzerM L, BigelowG E, LiebsonI A

Opiate dependence treatment
Relapse to illicit opiate use

Contingent delivery of a methadone dose supplement reduced relapse to illicit opiate use in patients undergoing methadone detoxification. The contingent group had significantly lower opiate-positive urines during the detoxification process.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

4.

Contingent methadone take-home doses reinforce adjunct therapy attendance of methadone maintenance patients.

Author: KidorfM, StitzerM L, BroonerR K, GoldbergJ

Drug abuse treatment
Therapy attendance
Drug use

Providing methadone take-home doses as reinforcement for therapy attendance in drug abuse patients increases their attendance. This approach may help deliver other services that can address the multiple challenges faced by opioid abusers.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

5.

Additional methadone increases craving for heroin: a double-blind, placebo-controlled study of chronic opiate users receiving methadone substitution treatment.

Author: CurranH V, BoltonJ, WanigaratneS, SmythC

Increased craving for heroin

Additional methadone may increase cravings for heroin in patients on long-term methadone substitution treatment.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

6.

Methadone doses of 100 mg or greater are more effective than lower doses at suppressing heroin self-administration in opioid-dependent volunteers.

Author: DonnyEric C, BrasserSusan M, BigelowGeorge E, StitzerMaxine L, WalshSharon L

Improved heroin dependence treatment
Heroin dependence

Methadone maintenance has been a successful treatment for heroin addiction for many years. Recent studies suggest that higher doses of methadone than typically used may be even more effective in reducing heroin use. This could be because higher doses create greater resistance to the pleasurable effects of heroin.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

7.

Efficacy of maintenance treatment with methadone for opioid dependence: a meta-analytical study.

Author: JohanssonBjörn Axel, BerglundMats, LindgrenAnna

Opioid dependence treatment
Methadone side effects

Methadone maintenance treatment for opioid dependence has been shown to improve patient retention, reduce opioid abuse, and decrease criminal activity.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Meta-AnalysisA statistical technique that integrates the results of multiple studies to draw more general conclusions about a particular issue.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

8.

Methadone-nicotine interactions in methadone maintenance treatment patients.

Author: ElkaderAlexander K, BrandsBruna, SelbyPeter, SprouleBeth A

Nicotine withdrawal relief
Opioid withdrawal relief
Increased drug liking

Methadone and nicotine interactions were observed in patients in methadone maintenance treatment (MMT), with smoking enhancing the effects of methadone on opioid withdrawal symptoms and vice versa.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

9.

Effects of a single 50% extra dose of methadone on heroin craving and mood in lower- versus higher-dose methadone patients.

Author: StrasserJohannes, WiesbeckGerhard A, MeierNatalie, StohlerRudolf, Dürsteler-MacfarlandKenneth M

Improved mood

This study examined the effects of a single extra half-dose of methadone on heroin craving, mood, and opioid-like symptoms in patients on stable methadone doses. The study found that a single 50% extra methadone dose was safe and may improve mood, potentially enhancing the attractiveness and effectiveness of maintenance treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

10.

Switching from methadone to diamorphine: 2-year results of the german heroin-assisted treatment trial.

Author: VertheinUwe, HaasenChristian, ReimerJens

Drug use reduction
Health improvement

Switching from methadone to diamorphine treatment improved health and drug use in opioid-dependent patients. In an analysis of a German trial, 90 patients who switched from methadone to diamorphine showed significant improvements in health and reduced use of street heroin and cocaine after 1 year of diamorphine treatment.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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