Psychiatric comorbidity and additional abuse of drugs in maintenance treatment with L- and D,L-methadone.
Sixty D,L- or L-methadone treated patients in maintenance therapy were interviewed for additional drug abuse and psychiatric comorbidity; 51.7% of the entire population had a comorbid Axis-I disorder, with a higher prevalence in females (P=0.05). Comorbid patients tended to have higher abuse of benzodiazepines, alcohol, cannabis, and cocaine, but not of heroin. They had received a significantly lower D,L- (P<0.05) and L-methadone dose than non-comorbid subjects. The duration of maintenance treatment showed an inverse relationship to frequency of additional heroin intake (P<0.01). Patients with additional heroin intake over the past 30 days had been treated with a significantly lower L-methadone dosage (P<0.05) than patients without. Axis-I comorbidity appears to be decreased when relatively higher dosages of D,L- (and L-methadone) are administered; comorbid individuals, however, were on significantly lower dosages. Finally, L-, but not D,L-methadone seems to be more effective in reducing additional heroin abuse.
Wedekind
Dirk
D
Department of Psychiatry, University of Goettingen, Goettingen, Germany. dwedeki1@gwdg.de
Jacobs
Stefan
S
Karg
Iris
I
Luedecke
Christel
C
Schneider
Udo
U
Cimander
Konrad
K
Baumann
Pierre
P
Ruether
Eckart
E
Poser
Wolfgang
W
Havemann-Reinecke
Ursula
U
D000328:Adult; D000701:Analgesics, Opioid / Q000737:chemistry / Q000627:therapeutic use*; D005260:Female; D006556:Heroin Dependence / Q000150:complications / Q000523:psychology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000523:psychology; D008691:Methadone / Q000737:chemistry / Q000627:therapeutic use*; D008875:Middle Aged; D013237:Stereoisomerism; D019966:Substance-Related Disorders / Q000150:complications / Q000523:psychology / Q000534:rehabilitation*; D055815:Young Adult
D000701:Analgesics, Opioid; D008691:Methadone