Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine

Autor: Ilkka Ojanperä, Pertti Heikman, Leea Hellevi Muhonen
Přispěvatelé: University of Helsinki, Clinicum, Department of Psychiatry, Medicum, Forensic Medicine, HUS Psychiatry
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
BUPRENORPHINE-NALOXONE
Craving
THERAPY
3124 Neurology and psychiatry
Benzodiazepines
0302 clinical medicine
DEPENDENCE
lcsh:Psychiatry
URINE
030212 general & internal medicine
Finland
biology
Time-of-flight mass spectrometry
Opioid-Related Disorders
Opiate Substitution Treatment
Middle Aged
Polydrug abuse
Buprenorphine
3. Good health
Analgesics
Opioid
Psychiatry and Mental health
Drug screening
Dose
Female
medicine.symptom
Research Article
medicine.drug
Adult
medicine.medical_specialty
Substance-Related Disorders
lcsh:RC435-571
DRUG-USE
03 medical and health sciences
Internal medicine
Naloxone
mental disorders
medicine
Humans
METHADONE
QUETIAPINE
Psychiatry
Retrospective Studies
Psychotropic Drugs
business.industry
Opioid maintenance treatment
Retrospective cohort study
MASS-SPECTROMETRY
PSYCHOACTIVE SUBSTANCES
biology.organism_classification
MISUSE
Cannabis
business
030217 neurology & neurosurgery
Methadone
Zdroj: BMC Psychiatry, Vol 17, Iss 1, Pp 1-11 (2017)
BMC Psychiatry
DOI: 10.1186/s12888-017-1415-y
Popis: Background: Polydrug abuse is a known problem among opioid-dependent patients receiving opioid maintenance treatment (OMT). However, improved laboratory diagnostics is required to reveal polydrug abuse in its current scope. Furthermore, there are few studies focusing on the relationship between polydrug abuse and adequacy of the dose of OMT medicine. This study aimed to evaluate the polydrug abuse among opioid-dependent patients receiving OMT with inadequate (Group IA) and adequate (Group A) doses of OMT medicine as experienced by the patients. Craving for opioids and withdrawal symptoms were evaluated as indicators of the adequacy rating. Methods: This is a retrospective register-based study of 60 OMT patients on either methadone or sublingual buprenorphine/naloxone medication, whose polydrug abuse was studied from urine samples by means of a comprehensive high-resolution mass spectrometry method. Results: Inadequate doses of the OMT medicines were associated with higher subjective withdrawal scores and craving for opioids. Six groups of abused substances (benzodiazepines, amphetamines, opioids, cannabis, new psychoactive substances, and non-prescribed psychotropic medicines) were found among OMT patients. Group IA patients showed significantly more abuse of benzodiazepines and amphetamines than the Group A patients. All the new psychoactive substances and most of the non-prescribed psychotropic medicines were detected from the Group IA patients. There was no difference in the doses of the OMT medicine between Groups IA and A patients. Conclusions: Polydrug abuse, detected by definitive laboratory methods, was widespread and more common among Group IA than Group A patients, emphasizing the requirement for individual OMT medicine dose adjustment.
Databáze: OpenAIRE
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