title: Differences in methylphenidate abuse rates among methadone maintenance treatment patients in two clinics.
abstract: Methylphenidate, an amphetamine-like prescription medication for attention deficit hyperactivity disorder (ADHD) was suspected as being abused among methadone maintenance treatment (MMT) patients. We tested its presence in the routine urine monitoring of all patients in both Tel Aviv and Las Vegas MMT clinics. Data on demographic and addiction history, ADHD (Wender Utah Rating Scale), cognitive impairment (Mini Mental State Exam), and lifetime DSM-IV-TR psychiatric diagnosis from admission were retrieved, and retention following 6 months. None of the 190 patients in Las Vegas tested positive for methylphenidate, while 14.7% (45/306) did in Tel Aviv. Abusers were less educated (p = 0.01), had higher ADHD scores (p = 0.02), lower cognitive scores (p = 0.05), and a higher benzodiazepine (BDZ) abuse rate (p < 0.0005), with no difference in age, gender, duration in MMT, cannabis, opiates, and cocaine abuse and infectious disease. Of the methylphenidate abuse 42.2% have take-home methadone dose privileges. Not like opiate use, being methylphenidate positive did not relate to 6-months retention. Compared to Tel Aviv, Las Vegas patients were more educated, with lower BDZ, and cocaine abuse. The greater abuse of methylphenidate among ADHD subjects might indicate their using it as self-medication, raising a possible indication for its prescription for that subgroup of MMT patients. The high rate of methylphenidate abuse in Israel needs future study.
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel. Electronic address: einatp@tlvmc.gov.il.
authors.forename: Einat
authors.initials: E
authors.lastname: Peles
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.
authors.forename: Shaul
authors.initials: S
authors.lastname: Schreiber
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Las Vegas, NV, USA.
authors.forename: Shirley
authors.initials: S
authors.lastname: Linzy
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Department of Psychiatry, Tel-Aviv Sourasky Medical Center & Tel-Aviv University Sackler Faculty of Medicine, Tel-Aviv, Israel.
authors.forename: Yoav
authors.initials: Y
authors.lastname: Domani
authors.affiliation: Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Tel-Aviv, Israel; Dr. Miriam & Sheldon G. Adelson Clinic for Drug Abuse, Treatment & Research, Las Vegas, NV, USA.
authors.forename: Miriam
authors.initials: M
authors.lastname: Adelson
mesh_terms: D000328:Adult; D001289:Attention Deficit Disorder with Hyperactivity / Q000188:drug therapy / Q000453:epidemiology; D001569:Benzodiazepines; D000697:Central Nervous System Stimulants; D003072:Cognition Disorders / Q000453:epidemiology; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000523:psychology; D008691:Methadone / Q000627:therapeutic use*; D008774:Methylphenidate; D008875:Middle Aged; D009294:Narcotics / Q000627:therapeutic use*; D009505:Nevada / Q000453:epidemiology; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D012651:Self Medication; D012959:Socioeconomic Factors; D016320:Substance Abuse Treatment Centers / Q000706:statistics & numerical data; D019966:Substance-Related Disorders / Q000453:epidemiology*; D055815:Young Adult
chemical_list: D000697:Central Nervous System Stimulants; D009294:Narcotics; D001569:Benzodiazepines; D008774:Methylphenidate; D008691:Methadone
keywords: ADHD; Abuse; Methadone maintenance treatment; Methylphenidate; Monitoring