CATAR Clinic

How many points did you get today?

FYI
Andy is voting against you...

Happy New Year Star When is my next appt? I feel like its been forever

You go girl!

Here's something I found in an article concerning methadone that I thought you might find interesting:
In the 1999 Federal regulations extend the treatment options of methadone-maintained opioid-dependent patients from specialized clinics to office-based opioid therapy (OBOT). OBOT allows primary care physicians to coordinate methadone therapy in this group with ongoing medical care. This patient group tends to be poorly understood and underserved. Methadone maintenance therapy is the most widely known and well-researched treatment for opioid dependency. Goals of therapy are to prevent abstinence syndrome, reduce narcotic cravings and block the euphoric effects of illicit opioid use. In the first phase of methadone treatment, appropriately selected patients are tapered to adequate steady-state dosing. Once they are stabilized on a satisfactory dosage, it is often possible to address their other chronic medical and psychiatric conditions. The maintenance phase can be used as a long-term therapy until the patient demonstrates the qualities required for successful detoxification. Patients who abuse narcotics have an increased risk for human immunodeficiency virus infection, hepatitis, tuberculosis and other conditions contributing to increased morbidity and mortality. Short- or long-term pain management problems and surgical needs are also common concerns in opioid-dependent patients and are generally treatable in conjunction with methadone maintenance. (Am Fam Physician 2001;63:2404-10.)

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Opioid dependence is a chronic, often relapsing, disorder that contributes to major medical challenges such as human immunodeficiency virus (HIV)-related illnesses, hepatitis and other chronic diseases. 1-3 While opioid-dependent patients are generally treated within rehabilitation programs that specifically target their addiction, family physicians, with their emphasis on regular and ongoing health maintenance, have the opportunity to treat a patient's addiction as well as other medical concerns.4,5 Major issues in the medical management of opioid dependency are outlined in Table 1.

Epidemiology

Between 500,000 and 1 million Americans are believed to be opioid dependent at any point in time.2,6,7 Gender differences exist, with opioid-related disorders more prevalent in men than women by a ratio of up to 4:1.2,8 Opioid dependency is often linked to a history of drug-related criminal activity.2 Antisocial personality disorder is more prevalent in opioid-dependent persons than in the general population,2,8,9 and opioid-dependent persons frequently have coexisting mood disorders, especially depression.2,4,9


Methadone maintenance therapy in opioid-dependent patients reduces illicit narcotic use, risk of contracting and transmitting HIV, tuberculosis and hepatitis, and illegal activities.



Treatment Options for Opioid Dependence

Methadone is the most widely known pharmacologic treatment for opioid dependence and is effective in reducing illicit narcotic use,10-12 retaining patients in treatment and decreasing illegal drug use.11,12 Ongoing methadone maintenance decreases the risk of contracting and transmitting HIV, hepatitis B (HBV) and hepatitis C (HCV)13,14 and is considered a cost-effective intervention.15 Long-term methadone maintenance is more successful in averting relapse than shorter-term treatment.12

Alternatives to methadone therapy include levomethadyl (Orlaam), buprenorphine (Buprenex), naltrexone (Trexan) and Narcotics Anonymous (NA). Levomethadyl's efficacy lasts as long as three days, while methadone requires daily dosing. Thus, levomethadyl therapy is appropriate in patients who do not require intensive care, but it is less effective in those who need daily monitoring. Buprenorphine (available for investigational use only) demonstrates dose-response ceiling effects, a factor that may operate as a safeguard and limit the potential for abuse or diversion.16 Methadone produces better treatment retention rates than buprenorphine,17,18 although results of studies of its superiority in decreasing illicit narcotic use are mixed.17-19 In contrast to methadone, naltrexone produces no physical dependence but has poor patient compliance rates. NA, a nonpharmacologic intervention, is a self-help peer recovery group that provides social support.

I just wanted to tell you that I think you are a wonderful person!

I also gave you a 5 star rating!

Would you please rate me too?

I don't see any broken windows...
Then I don't see anything either
????

When is the day again?

thanks for comment. Love the poem, which sounds like a person in the know who is really serious about their recovery. Need more positive talk from patients who know and are serious.

be my friend

You have been challenged