Use of 'very low-dose phenobarbital' to investigate compliance in patients on reducing doses of methadone (detoxification).
Incorporation of very low doses of phenobarbital into a methadone linctus has enabled us to monitor the compliance of 7 patients receiving a reducing dose of methadone (detoxification) for treatment for opioid addiction. By measuring both plasma phenobarbital and methadone we detected 4 patients who consumed extra illicitly obtained methadone during the detoxification regime. Treatment outcome was poor; 11 of the original 18 patients dropped out of treatment within 14 days and of those who remained, 4 patients relapsed and reabused illicit drugs and 2 returned to a fixed dose of methadone. Laboratory measurements were successfully used to detect poor methadone compliance.
Wolff
K
K
Department of Chemical Pathology and Immunology, Old Medical School, University of Leeds, UK.
Hay
A A
AA
Raistrick
D
D
Feely
M
M
D000328:Adult; D002851:Chromatography, High Pressure Liquid; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D009293:Opioid-Related Disorders / Q000097:blood / Q000523:psychology / Q000534:rehabilitation*; D010349:Patient Compliance / Q000523:psychology*; D010634:Phenobarbital / Q000008:administration & dosage* / Q000009:adverse effects / Q000493:pharmacokinetics; D015813:Substance Abuse Detection; D013375:Substance Withdrawal Syndrome / Q000097:blood / Q000517:prevention & control* / Q000523:psychology
D008691:Methadone; D010634:Phenobarbital