Self-reported effects of methadone on cigarette smoking in methadone-maintained subjects.

Subjects maintained on methadone evidence a high level of interest in quitting cigarette smoking. Readiness to quit may result, at least partially, from direct pharmacological interactions between methadone and brain nicotinic acetylcholine receptors. The aim of the present study was to assess: (1) self-reported changes in smoking habits after admission to a methadone maintenance treatment (MMT) program; (2) acute effects of methadone administration on smoking behavior in MMT patients. The study was conducted between May and December 2001, in two public outpatient MMT clinics located in Warsaw, Poland. The patients (41 men, 30 women) reported smoking fewer cigarettes after admission to the program. Most subjects (67.6%) changed their favorite brand of cigarettes after admission. Mean nicotine content (mg/cigarette) significantly decreased. On the other hand, the subjects did not report any effects of methadone administration on smoking parameters. The above findings suggest that initiation of MMT is associated with positive changes in smoking behavior. However, these changes may not be related to direct pharmacological interactions between methadone and nicotine.

Excretion profile of opiates in dependent patients in relation to route of administration and type of drug measured in urine with immunoassay.

It is accepted that opiates are detectable in urine within three days from the last dose at a cut-off value of 300 ng/mL. In our clinical practice, some patients tested positive for morphine even after a week of detoxification. The present study evaluates the time course of opiate excretion in urine of dependent subjects (F11.25 according to ICD-10) in relation to route of administration and a kind of street heroin. The group comprised 71 men treated for opiate dependency: 33 of them used heroin exclusively by inhalation; 26 i.v.; 12 used i.v. homemade poppy straw decoctions. Opiate levels were measured once a day by fluorescence polarization immunoassay (TDx Abbott). Detection time ranged from 3 to 10 days for cut-off value 300 ng/mL and from less than one up to seven days for cut-off value 2000 ng/mL. The increases in urine drug concentration that result from changes in urinary output may be mistakenly interpreted as a new drug use. Normalization of drug excretion to urine creatinine concentration reduces the variability of drug measurement attributable to urine dilution. The time function of creatinine normalized opiate concentration has a log-linear character, and decreases at a rate of 2.5 per day on average. New "normalized" cut-off values were proposed: 225 ng/mg creatinine, 1500 ng/mg creatinine, and 3750 ng/mg creatinine that corresponds to 300 ng/mL urine, 2000 ng/mL urine, and 5000 ng/mL urine.

[Bupropion in cigarettes smoking cessation by former polydrug user participating in methadone maintenance programme]. / Bupropion w zaprzestaniu palenia tytoniu przez uczestnika programu metadonowego uzaleznionego od opiatów, amfetaminy, tytoniu.

There was described and discussed a case of methadone maintenance participant, former polydrug abuser, who has received a standard treatment with bupropion SR for smoking cessation. Because of substance abuse in the past, eeg was monitored. Treatment was successful: patient stays abstinent since 5 months, neither seizures nor worsening of eeg were observed.

The activity of beta-hexosaminidase (uHex) and gamma-glutamyltransferase (uGGT) in urine as non-invasive markers of chronic alcohol abuse: II. Opiate-dependent subjects receiving methadone substitution.

The usefulness of beta-hexosaminidase (uHex) and gamma-glutamyltransferase (uGGT) activity in urine as markers of chronic alcohol abuse was examined in male methadone programme participants. The group consisted of 24 non-abusing and 21 alcohol-abusing men. It has been demonstrated that the uHex test is one of the best alcohol abuse markers for opiate-dependent individuals (Receiver Operating Characteristic (ROC) area under the curve (AUC) 0.82, sensitivity 0.70, specificity 0.82). The uGGT test can be used as a marker of alcohol abuse in opiate-dependent men, however, its parameters are worse than those of uHex (ROC AUC 0.73, sensitivity 0.71, specificity 0.77). Among serum markers, only the relative amount of carbohydrate-deficient transferrin (s%CDT) has parameters sufficient for diagnostic use (ROC AUC 0.74, sensitivity 0.60, specificity 0.86). Factors other than alcohol can render the commonly used sGGT and sHex tests useless (differences between means for abusing and abstinent patients were insignificant, AUC ROC were lower than 0.7-0.65 and 0.69, respectively). Their good parameters, low costs, ease of use and non-invasive character are all features which make uHex and uGGT highly useful tools in the detection of chronic alcohol abuse in opiate-dependent patients participating in a methadone substitution programme.

[Subjective Quality of Life in opiate-dependent patients before admission after six months and one-year participation in methadone program]. / Subiektywna ocena jakosci zycia przez pacjentów uzaleznionych od opiatów przed przyjeciem, po 6 miesiacach i po roku uczestniczenia w programie metadonowym.

The aim of this study was to compare a subjective Quality of Life (QoL) assessment before, after six and twelve months of participating in methadone program. There were included 61 patients (39 males and 22 females). The SF-36 questionnaire was used. We found that in our patients before admission to methadone program QoL was extremely low. After six-months participation in substitution therapy QoL increased significantly in seven from eight subscales of SF-36. During next six months QoL unexpectedly decrease, but not to prior level. There were not significant differences in QoL between men and women although men beneficiated from methadone program more than women. In our study HIV seropositivity hadn't influence on QoL.

Taste function in methadone-maintained opioid-dependent men.

It has been shown repeatedly that opioid dependence is associated with increased consumption of refined sugars. It is possible that this association results from altered taste reactivity in opioid-dependent subjects. Thus, in the present study, we compared taste responses to sweet, bitter, sour and salty solutions in methadone-maintained opioid-dependent men and healthy control subjects. The two groups did not differ in terms of rated intensity or pleasantness of sucrose (1-30%), quinine (0.001-0.005%), citric acid (0.02-0.1%) and sodium chloride (0.18-0.9%) solutions. Proportions of 'sweet-likers', i.e. subjects rating a 30% sucrose (0.88 M) solution as the most pleasant, were also similar in both groups. In line with the previous findings, the methadone-maintained subjects reported adding more table sugar to caffeinated beverages. The results of the present study suggest that changes in taste reactivity may not be responsible for altered dietary choices in opioid addicts.