Comparison of Client Satisfaction Between Those Treated for Opioid Dependence With Oral Methadone Versus Injectable Heroin

(Comparison of Client Satisfaction Between Those Treated for Opioid Dependence With Oral Methadone Versus Injectable Heroin) "Among long-term chronic opioid injectors participating in a randomized clinical trial prescribing injectable diacetylmorphine or hydromorphone and oral methadone, those receiving injectable medications were more satisfied with treatment. Independent of treatment group, treatment satisfaction was also an indicator of retention in treatment, as well as treatment response, including a reduction in substance use.

Methadone vs. Buprenorphine Treatment

(Methadone vs. Buprenorphine Treatment) "Opioid dependence and addiction, whether to heroin or prescription pain relievers, is a serious, life-threatening medical condition. Methadone and buprenorphine are medications that permit addicted individuals to function normally within their families, jobs, and communities. While treatment with methadone is more established, it requires daily visits to an OTP. Not all individuals who could benefit from methadone treatment live within easy travelling distance of an OTP.

Efficacy of Naltrexone Treatment

(Efficacy of Naltrexone Treatment) "Studies conducted in St. Petersburg, Russia, for more than a decade have demonstrated the efficacy and safety of different naltrexone formulations (oral, implantable, injectable) for relapse prevention and maintenance of abstinence in detoxified opioid addicts. The positive results from different formulations seem related to two cultural factors. One is that relatives can be recruited to supervise daily dosing of the oral formulation. However, this advantage is decreasing as the addicted population ages.

Availability of Naltrexone in Russian Federation

(Availability of Naltrexone in Russian Federation) "In Russia, substitution therapy is forbidden by law, and naltrexone is the only available pharmacotherapy for heroin dependence. Due to the lack of alternatives to naltrexone and stronger family control of compliance (adherence), naltrexone is more effective for relapse prevention and abstinence stabilization in Russia than in Western countries. Long-acting, sustained-release formulations (injectable and implantable) seem particularly effective compared with oral formulations."

Efficacy of Long-Acting Injectable Naltrexone

(Efficacy of Long-Acting Injectable Naltrexone) "A randomized, double-blind, placebo-controlled trial examined the treatment efficacy of long-acting injectable naltrexone (Naltrel, DrugAbuse Sciences) for relapse prevention in 60 heroin-dependent i­ndividuals. Patients were stratified by sex and years of heroin use and randomized to receive placebo, 192 mg, or 384 mg of long-acting naltrexone intramuscular injections dosed on weeks 1 and 5. In addition to ­medication, patients received relapse prevention therapy and had urine monitored for drug relapse.

Sustained Release Naltrexone Implants

(Sustained Release Naltrexone Implants) "In order to overcome the issues of poor t­reatment adherence with oral naltrexone, a number of sustained-release implants have been developed internationally for use in alcohol and opioid dependence. A non-randomized retrospective review examined two types of sustained-release naltrexone implants, oral naltrexone, and historical controls revealed a significant difference between immediate and sustained-­release injectable naltrexone in individuals opioid-free 12 months after initiating treatment.

Methadone Treatment

(Methadone Treatment) "There are numerous benefits of methadone use during pregnancy, including improved prenatal care,12,107–109 longer gestation,50,110 higher birth weight,111,112 and increased rates of infants discharged home in the care of their mothers.4,12,18,49,101,108,113–118 Although infants of methadone-treated women tend to be smaller (lower birth weight, length, and head circumference) than drug-free controls, studies have shown a catch-up of growth by 12 months of age.118,119"

Regulation and Certification of Opioid Treatment Programs (OTPs)

Laws and Policies

(Regulation and Certification of Opioid Treatment Programs (OTPs)) "Methadone, in use since 1964 for the treatment of opioid dependence, may be dispensed only in federally approved Opioid Treatment Programs (OTPs). Treatment protocols require that a client take the medication at the clinic where it is dispensed daily.4 Take-home dosages are allowed only for clients who have been on an established maintenance program for an extended period of time.