title: A pilot study to determine the usefulness of the urinary excretion of methadone and its primary metabolite (EDDP) as potential markers of compliance in methadone detoxification programs.
abstract: Fourteen subjects (selected on the basis of compliance with the methadone-maintenance program prescribed by the consultant psychiatrist in charge of their treatment) undergoing opiate detoxification by methadone-replacement therapy were studied to determine if a relationship exists between the dose of methadone prescribed and the urinary excretion of methadone and/or its primary metabolite, 2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine (EDDP). After the derivation of this relationship, it was hoped that the urinary concentrations of methadone and/or EDDP could be used as a noninvasive technique to monitor the methadone compliance of 56 drug abusers. Despite statistically significant correlations (p<0.001) between methadone dose and urine concentrations of methadone and EDDP, the large variation in concentrations measured in the urine of drug abusers negated the possibility of any clear-cut relationship being confirmed. However, it may be possible to use excretion data to monitor individual compliance but only through long-term monitoring of individual subjects to establish their own intraindividual variation in excretion patterns.
authors: Regional Laboratory for Toxicology, City Hospital NHS Trust, Birmingham, England.
authors: S
authors: S
authors: George
authors: R A
authors: RA
authors: Braithwaite
mesh_terms: D000328:Adult; D015415:Biomarkers; D004305:Dose-Response Relationship, Drug; D016903:Drug Monitoring; D005260:Female; D006801:Humans; D008297:Male; D008691:Methadone / Q000378:metabolism / Q000652:urine*; D009294:Narcotics / Q000652:urine*; D009293:Opioid-Related Disorders / Q000517:prevention & control; D010349:Patient Compliance; D010599:Pharmacokinetics; D010865:Pilot Projects; D011759:Pyrrolidines / Q000652:urine*; D011897:Random Allocation
chemical_list: D015415:Biomarkers; D009294:Narcotics; D011759:Pyrrolidines; D008691:Methadone; C010724:2-ethylidene-1,5-dimethyl-3,3-diphenylpyrrolidine