QT interval screening in methadone maintenance treatment: report of a SAMHSA expert panel.
In an effort to enhance patient safety in opioid treatment programs, the Substance Abuse and Mental Health Saervices Administration convened a multi-disciplinary Expert Panel on the Cardiac Effects of Methadone. Panel members (Appendix A) reviewed the literature, regulatory actions, professional guidances, and opioid treatment program experiences regarding adverse cardiac events associated with methadone. The Panel concluded that, to the extent possible, every opioid treatment program should have a universal Cardiac Risk Management Plan (incorporating clinical assessment, electrocardiogram assessment, risk stratification, and prevention of drug interactions) for all patients and should strongly consider patient-specific risk minimization strategies (such as careful patient monitoring, obtaining electrocardiograms as indicated by a particular patient's risk profile, and adjusting the methadone dose as needed) for patients with identified risk factors for adverse cardiac events. The Panel also suggested specific modifications to informed consent documents, patient education, staff education, and methadone protocols.
BAART Turk Street Clinic, San Francisco, CA, USA.
Judith A
JA
Martin
Anthony
A
Campbell
Thomas
T
Killip
Margaret
M
Kotz
Mori J
MJ
Krantz
Mary Jeanne
MJ
Kreek
Brian A
BA
McCarroll
Davendra
D
Mehta
J Thomas
JT
Payte
Barry
B
Stimmel
Trusandra
T
Taylor
Mark C P
MC
Haigney
Bonnie B
BB
Wilford
D006801:Humans; D008133:Long QT Syndrome / Q000139:chemically induced* / Q000175:diagnosis; D008691:Methadone / Q000009:adverse effects* / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000009:adverse effects*; D009293:Opioid-Related Disorders / Q000188:drug therapy; D061214:Patient Safety / Q000592:standards*; D016171:Torsades de Pointes / Q000517:prevention & control; D014481:United States; D014482:United States Substance Abuse and Mental Health Services Administration
D008691:Methadone