title: Association between methadone dose and concomitant cocaine use in methadone maintenance treatment: a register-based study.
abstract: BACKGROUND
  Concomitant cocaine use is a major problem in clinical practice in methadone maintenance treatment (MMT) and may interfere with successful treatment. Data from European methadone populations is sparse. This register-based study sought to explore the association between prescribed methadone dose and concomitant cocaine and heroin use in the methadone population of Basel City.
  
  
  METHODS
  The study included 613 methadone patients between April 1, 2003 and March 31, 2004. Anonymized data was taken from the methadone register of Basel City. For analysis of the prescribed methadone dose distribution, the patient sample was split into three methadone dosage groups: a low dose group (LDG) (n = 200; < 60 mg/day), a medium dose group (MDG) (n = 273; 60 to 100 mg/day), and a high dose group (HDG) (n = 140; > 100 mg/day). Concomitant drug use was based on self-report.
  
  
  RESULTS
  Analysis showed a significant difference in self-reported cocaine use between groups (p < 0.001). Patients in the LDG reported significantly fewer cocaine consumption days compared to the MDG (p < 0.001) and the HDG (p < 0.05). Patients in the HDG reported significantly fewer heroin consumption days than those in the LDG (p < 0.01) and the MDG (p < 0.001). In logistic regression analysis, cocaine use was significantly associated with heroin use (OR 4.9).
  
  
  CONCLUSIONS
  Cocaine use in methadone patients may be associated with heroin use, which indicates the importance of prescribing appropriate methadone dosages in order to indirectly reduce cocaine use.
authors.affiliation: Outpatient Addiction Treatment Center Reinach, Psychiatry Baselland, Baselstrasse 1, 4153 Reinach, Switzerland. marcus.baumeister@pbl.ch.
authors.forename: Marcus
authors.initials: M
authors.lastname: Baumeister
authors.forename: Marc
authors.initials: M
authors.lastname: Vogel
authors.forename: Kenneth M
authors.initials: KM
authors.lastname: Dürsteler-MacFarland
authors.forename: Urs
authors.initials: U
authors.lastname: Gerhard
authors.forename: Johannes
authors.initials: J
authors.lastname: Strasser
authors.forename: Marc
authors.initials: M
authors.lastname: Walter
authors.forename: Gerhard A
authors.initials: GA
authors.lastname: Wiesbeck
authors.forename: Sylvie A
authors.initials: SA
authors.lastname: Petitjean
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000453:epidemiology*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006556:Heroin Dependence / Q000453:epidemiology* / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D058850:Opiate Substitution Treatment / Q000009:adverse effects / Q000379:methods / Q000706:statistics & numerical data*; D009293:Opioid-Related Disorders / Q000534:rehabilitation; D011795:Surveys and Questionnaires; D013557:Switzerland; D055815:Young Adult
chemical_list: D009294:Narcotics; D008691:Methadone