title: Non-prescribed drug use during methadone treatment by clinic- and community-based patients.
abstract: We investigated the efficacy of methadone maintenance treatment in clinic-based (n = 10) and community-based (n = 10) patients by studying the relationships between dose, plasma concentrations of methadone and non-prescribed drug-use using logistic regression. We found that clinic-based patients had significantly reduced odds of having a urine sample test positive for illicit drugs when compared to community-based patients (OR = 0.20; 95% confidence interval 0.10-0.38: p < 0.001). There was no relationship between either methadone dose or plasma methadone concentration and testing positive for non-prescribed drugs (including cocaine, cannabis, amphetamine, ecstasy, benzodiazepines). We looked specifically at the misuse of opiate drugs. Location was again important and clinic-based patients had significantly reduced odds of having a urine sample test positive for opiate drugs (OR = 0.36, 95% confidence interval 0.18-0.71: p approximately 0.004). Opiate drug use in our patients was also significantly related to plasma methadone concentration, increasing noticeably when the drug concentration < 0.48 nmol/L (p approximately 0.04). We found no relationship between methadone dose and odds of having a positive urine drug test in either clinic- or community-based patients.
authors.affiliation: Division of Pathology, Research School of Medicine, University of Leeds, UK.
authors.forename: K
authors.initials: K
authors.lastname: Wolff
authors.forename: A W
authors.initials: AW
authors.lastname: Hay
authors.forename: A
authors.initials: A
authors.lastname: Vail
authors.forename: K
authors.initials: K
authors.lastname: Harrison
authors.forename: D
authors.initials: D
authors.lastname: Raistrick
mesh_terms: D000328:Adult; D003156:Community Mental Health Services; D016001:Confidence Intervals; D004305:Dose-Response Relationship, Drug; D005260:Female; D006556:Heroin Dependence / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage*; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage*; D015813:Substance Abuse Detection / Q000706:statistics & numerical data; D016320:Substance Abuse Treatment Centers; D016896:Treatment Outcome
chemical_list: D009294:Narcotics; D008691:Methadone