title: Pharmacotherapy in the treatment of addiction: methadone.
abstract: Methadone maintenance treatment (MMT) is the most widely available pharmacotherapy for opioid addiction and has been shown to be an effective and safe treatment over a period of 40 years. Although women comprise approximately 40% of clients currently being treated in MMT programs, comparatively little research geared specifically toward this group has been published. This article begins with an overview of neurobiological studies on opioid addiction, including a discussion of gender differences, followed by a review of the pharmacology of methadone. The authors then examine the particular needs and differences of women being treated in MMTs, including co-dependence with other substances, women's health issues, and psychosocial needs unique to this population. Research shows that women have different substance abuse treatment needs in comparison to their male counterparts. One New York City MMT program that has attempted to address these differences is highlighted.
authors.affiliation: Laboratory of the Biology of Addictive Diseases, The Rockefeller University, New York, NY 10065, USA. kreek@rockefeller.edu
authors.forename: Mary Jeanne
authors.initials: MJ
authors.lastname: Kreek
authors.forename: Lisa
authors.initials: L
authors.lastname: Borg
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Ducat
authors.forename: Brenda
authors.initials: B
authors.lastname: Ray
mesh_terms: D000701:Analgesics, Opioid / Q000494:pharmacology* / Q000627:therapeutic use; D001294:Attitude to Health; D016739:Behavior, Addictive / Q000188:drug therapy / Q000534:rehabilitation; D005260:Female; D006556:Heroin Dependence / Q000523:psychology / Q000534:rehabilitation*; D006801:Humans; D008691:Methadone / Q000494:pharmacology* / Q000627:therapeutic use; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone
references.citation: J Pharmacol Exp Ther. 1999 May;289(2):1048-53
references.pmid: 10215686
references.citation: Drug Alcohol Depend. 1980 Mar;5(3):197-205
references.pmid: 6986247
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2008 Sep 5;147B(6):793-8
references.pmid: 18270997
references.citation: J Pharmacol Exp Ther. 2000 Dec;295(3):1070-6
references.pmid: 11082442
references.citation: Ann N Y Acad Sci. 1978;311:110-34
references.pmid: 369431
references.citation: J Subst Abuse Treat. 2008 Mar;34(2):208-14
references.pmid: 17596905
references.citation: Addiction. 2003 Mar;98(3):269-79
references.pmid: 12603227
references.citation: Drug Alcohol Depend. 1993 Oct;33(3):235-45
references.pmid: 8261888
references.citation: Synapse. 2005 Sep 1;57(3):160-6
references.pmid: 15945065
references.citation: Ann N Y Acad Sci. 1976;281:350-71
references.pmid: 798526
references.citation: Eur J Clin Pharmacol. 1982;22(4):343-9
references.pmid: 7106170
references.citation: J Clin Psychopharmacol. 2001 Apr;21(2):229-34
references.pmid: 11270921
references.citation: J Addict Dis. 1999;18(4):51-61
references.pmid: 10631963
references.citation: Addiction. 2005 Oct;100(10):1496-509
references.pmid: 16185211
references.citation: Addiction. 2005 Jun;100(6):829-36
references.pmid: 15918813
references.citation: Drug Intell Clin Pharm. 1987 Oct;21(10):773-83
references.pmid: 3322755
references.citation: Addiction. 2007 Feb;102(2):289-300
references.pmid: 17222284
references.citation: J Clin Endocrinol Metab. 1996 Feb;81(2):437-42
references.pmid: 8636244
references.citation: MMWR Morb Mortal Wkly Rep. 1984 Jul 13;33(27):377-9
references.pmid: 6330518
references.citation: Addict Behav. 2007 Oct;32(10):2108-19
references.pmid: 17335982
references.citation: J Addict Dis. 2005;24(3):23-47
references.pmid: 16186081
references.citation: N Y State J Med. 1973 Dec 1;73(23):2773-7
references.pmid: 4520357
references.citation: Trans Assoc Am Physicians. 1966;79:122-36
references.pmid: 4162906
references.citation: Am J Epidemiol. 1991 Mar 15;133(6):590-8
references.pmid: 2006646
references.citation: Ann Intern Med. 1998 Aug 1;129(3):229-40
references.pmid: 9696732
references.citation: J Psychoactive Drugs. 1999 Apr-Jun;31(2):95-102
references.pmid: 10437990
references.citation: Addiction. 2005 Jun;100(6):820-8
references.pmid: 15918812
references.citation: Drug Alcohol Depend. 2006 May 20;82(3):211-7
references.pmid: 16219428
references.citation: Gastroenterology. 1978 Jul;75(1):88-94
references.pmid: 401102
references.citation: J Clin Pharmacol. 1980 Aug-Sep;20(8-9):506-13
references.pmid: 7430415
references.citation: Arch Intern Med. 1966 Oct;118(4):304-9
references.pmid: 4162686
references.citation: Int J STD AIDS. 1995 May-Jun;6(3):201-3
references.pmid: 7647124
references.citation: J Subst Abuse Treat. 2007 Jul;33(1):91-8
references.pmid: 17588494
references.citation: Biol Psychiatry. 2005 Jun 15;57(12):1573-82
references.pmid: 15953495
references.citation: Addiction. 2004 Jan;99(1):21-4
references.pmid: 14678055
references.citation: J Pharmacol Exp Ther. 1985 Apr;233(1):1-6
references.pmid: 3981450
references.citation: Psychopharmacology (Berl). 2005 Mar;178(2-3):167-73
references.pmid: 15322728
references.citation: Am Rev Respir Dis. 1990 Oct;142(4):895-909
references.pmid: 2171388
references.citation: Proc Natl Acad Sci U S A. 1998 Aug 4;95(16):9608-13
references.pmid: 9689128
references.citation: Neuropsychopharmacology. 2006 Oct;31(10):2313-7
references.pmid: 16794569
references.citation: J Pharm Sci. 1977 Nov;66(11):1579-82
references.pmid: 915734
references.citation: Am J Drug Alcohol Abuse. 1993;19(4):465-74
references.pmid: 8273767
references.citation: Proc Natl Acad Sci U S A. 1973 Jan;70(1):10
references.pmid: 4509643
references.citation: Am J Cardiol. 2003 Oct 15;92(8):995-7
references.pmid: 14556883
references.citation: Drug Alcohol Depend. 2000 Feb 1;58(1-2):43-54
references.pmid: 10669054
references.citation: J Addict Dis. 2006;25(1):43-50
references.pmid: 16597572
references.citation: Am J Cardiol. 2005 Apr 1;95(7):915-8
references.pmid: 15781034
references.citation: JAMA. 1965 Aug 23;193:646-50
references.pmid: 14321530
references.citation: J Subst Abuse Treat. 1992 Fall;9(4):319-25
references.pmid: 1479629
references.citation: JAMA. 1968 Dec 16;206(12):2708-11
references.pmid: 5754883
references.citation: Neuropharmacology. 2009;56 Suppl 1:32-43
references.pmid: 18725235
references.citation: J Addict Dis. 2006;25(2):39-45
references.pmid: 16785218
references.citation: J Addict Dis. 1999;18(4):63-75
references.pmid: 10631964
references.citation: Am J Perinatol. 2006 Jul;23(5):287-94
references.pmid: 16799915
references.citation: Neuropsychopharmacology. 2005 Feb;30(2):417-22
references.pmid: 15525999
references.citation: Psychol Addict Behav. 2004 Jun;18(2):180-3
references.pmid: 15238060
references.citation: Brain Res. 1992 Jul 3;584(1-2):314-8
references.pmid: 1325249
references.citation: Res Commun Chem Pathol Pharmacol. 1980 Jul;29(1):67-78
references.pmid: 7403680
references.citation: Obstet Gynecol. 1974 Nov;44(5):713-9
references.pmid: 4479341
references.citation: Ann Intern Med. 2003 Jul 15;139(2):154-5
references.pmid: 12859171
references.citation: J Clin Pharmacol. 2007 May;47(5):604-12
references.pmid: 17400820
references.citation: Nat Rev Drug Discov. 2002 Sep;1(9):710-26
references.pmid: 12209151
references.citation: J Subst Abuse Treat. 2003 Oct;25(3):125-34
references.pmid: 14670518
references.citation: Addiction. 2008 Mar;103(3):462-8
references.pmid: 18190664
references.citation: Am J Drug Alcohol Abuse. 2007;33(2):291-9
references.pmid: 17497552
references.citation: Drug Alcohol Depend. 1993 Sep;33(2):105-17
references.pmid: 8261875
references.citation: J Subst Abuse Treat. 2001 Mar;20(2):121-7
references.pmid: 11306214
references.citation: Mol Psychiatry. 2004 Jun;9(6):547-9
references.pmid: 15037869
references.citation: Life Sci. 1979 Mar 5;24(10):925-32
references.pmid: 449601
references.citation: Neuropharmacology. 2004;47 Suppl 1:324-44
references.pmid: 15464148
references.citation: Clin Pharmacol Ther. 2005 Mar;77(3):214-24
references.pmid: 15735615
references.citation: Am J Addict. 2001;10(s1):s60-s69
references.pmid: 11268822
references.citation: Eur J Clin Pharmacol. 1993;44(2):189-94
references.pmid: 8453965
references.citation: Clin Pharmacokinet. 2002;41(14):1153-93
references.pmid: 12405865
references.citation: NIDA Res Monogr. 1987;76:53-62
references.pmid: 3125471
references.citation: J Acquir Immune Defic Syndr. 2006 Apr 15;41(5):563-72
references.pmid: 16652030
references.citation: Hum Mol Genet. 2008 Jul 15;17(14):2219-27
references.pmid: 18424454
references.citation: Aust J Rural Health. 2003 Jan;11(1):2-6
references.pmid: 12603439
references.citation: J Addict Dis. 1995;14(3):83-96
references.pmid: 8555281
references.citation: Soc Work Health Care. 2007;45(4):43-62
references.pmid: 17954448
references.citation: Drug Alcohol Depend. 2008 Apr 1;94(1-3):199-206
references.pmid: 18243585
references.citation: Pharmacol Rev. 2005 Mar;57(1):1-26
references.pmid: 15734726
references.citation: Drug Alcohol Depend. 1998 Nov 1;52(3):257-60
references.pmid: 9839152
references.citation: Res Publ Assoc Res Nerv Ment Dis. 1968;46:359-66
references.pmid: 5723803
references.citation: Pharmacotherapy. 2005 Nov;25(11):1523-9
references.pmid: 16232014
references.citation: N Engl J Med. 1984 May 10;310(19):1213-7
references.pmid: 6709027
references.citation: J Opioid Manag. 2007 Jan-Feb;3(1):27-34
references.pmid: 17367092
references.citation: Mol Interv. 2007 Apr;7(2):74-8
references.pmid: 17468387
references.citation: J Addict Dis. 2002;21(3):1-12
references.pmid: 12094996
references.citation: Eur Addict Res. 2006;12(2):109-12
references.pmid: 16543747
references.citation: J Pharmacol Exp Ther. 1999 Jan;288(1):260-9
references.pmid: 9862779
references.citation: Pharmacol Res. 2004 Dec;50(6):551-9
references.pmid: 15501692
references.citation: Am J Public Health. 2005 Mar;95(3):465-70
references.pmid: 15727978
references.citation: Pediatrics. 1994 Jan;93(1):137-50
references.pmid: 8265310
references.citation: Aust N Z J Psychiatry. 2003 Aug;37(4):458-63
references.pmid: 12873331
references.citation: Am J Epidemiol. 1974 Aug;100(2):101-12
references.pmid: 4850534
references.citation: Subst Abuse Treat Prev Policy. 2006 Sep 07;1:26
references.pmid: 16959041
references.citation: Am J Drug Alcohol Abuse. 1986;12(1-2):1-16
references.pmid: 3788892
references.citation: Violence Vict. 1998 Summer;13(2):107-15
references.pmid: 9809391
references.citation: J Pain Palliat Care Pharmacother. 2005;19(4):13-24
references.pmid: 16431829
references.citation: N Engl J Med. 1976 May 13;294(20):1104-6
references.pmid: 1256526
references.citation: J Subst Abuse Treat. 1990;7(2):101-7
references.pmid: 2388310
references.citation: Am J Public Health. 1995 Jan;85(1):83-8
references.pmid: 7832267
references.citation: Ir Med J. 2007 Mar;100(3):393-7
references.pmid: 17491538
references.citation: J Addict Dis. 1995;14(1):67-74
references.pmid: 7632748
references.citation: Alcohol Clin Exp Res. 1985 Jul-Aug;9(4):349-54
references.pmid: 3901806
references.citation: Alcohol Clin Exp Res. 1986 Oct;10(5):500-5
references.pmid: 3541673
references.citation: Subst Use Misuse. 1998 Oct;33(12):2441-67
references.pmid: 9781824
references.citation: CNS Drugs. 2007;21(3):213-37
references.pmid: 17338593
references.citation: JAMA. 1973 Feb 5;223(6):665-8
references.pmid: 4739193
references.citation: Drug Alcohol Depend. 2004 May 10;74(2):177-85
references.pmid: 15099661
references.citation: Biochem Pharmacol. 2004 Aug 1;68(3):583-91
references.pmid: 15242824
references.citation: Nat Med. 1996 Nov;2(11):1225-9
references.pmid: 8898749
references.citation: Bull Narc. 1986 Jan-Jun;38(1-2):15-25
references.pmid: 3779178
references.citation: Psychopharmacology (Berl). 1999 Apr;143(4):385-93
references.pmid: 10367556
references.citation: Clin Ther. 2007 Jan;29(1):131-8
references.pmid: 17379053
references.citation: J Pharmacol Exp Ther. 2003 Aug;306(2):581-7
references.pmid: 12730354
references.citation: Clin Pharmacol Ther. 1981 Sep;30(3):353-62
references.pmid: 7273599
references.citation: Pediatrics. 2008 Nov;122(5):1127-34
references.pmid: 18977995
references.citation: Ann Intern Med. 2002 Sep 17;137(6):501-4
references.pmid: 12230351
references.citation: Ann Intern Med. 1981 Mar;94(3):349-51
references.pmid: 7224382
references.citation: J Affect Disord. 2007 Apr;99(1-3):213-20
references.pmid: 17055063
references.citation: Drug Alcohol Rev. 2007 Jan;26(1):55-63
references.pmid: 17364837
references.citation: Clin Pharmacol Ther. 2008 Apr;83(4):615-8
references.pmid: 18323858
references.citation: Biomed Mass Spectrom. 1980 Sep;7(9):385-95
references.pmid: 7470591
references.citation: J Subst Abuse Treat. 2000 Jul;19(1):7-14
references.pmid: 10867295