Dose-response effects of methadone in the treatment of opioid dependence

Research output: Contribution to journalArticle

Abstract

Objective: To compare the dose effectiveness of low to moderate doses of methadone in a sample of a contemporary population of opioid abusers, because the optimal dosing of methadone in the treatment of opioid dependence remains an issue. Design: A randomized, double-blind, placebocontrolled study. Setting: A methadone treatment research clinic. Patients: Participants (n = 247) were opioid-dependent patients with a high rate of cocaine use. Intervention: All participants were initially treated with active methadone for a minimum of 5 weeks and then received 15 weeks of stable dosing at 50, 20, or 0 mg per day. Individual counseling and group therapy were included. Measurements: Treatment retention and illicit drug use as determined by intensive urine monitoring. Results: Retention was better for patients who remained on active medication. By treatment week 20, retention was 52.4% for the 50-mg, 41.5% for the 20-mg, and 21.0% for the 0-mg group (50 versus 0 and 20 versus 0, P <0.05; 50 versus 20, P > 0.05). Only the 50-mg treatment group had a reduced rate of opioid-positive urine samples (56.4% versus 67.6% and 73.6% for the 20-mg and 0-mg groups, respectively; P <0.05) and cocaine-positive urine samples (52.6% versus 62.4% and 67.1% for the 20- and 0-mg groups, respectively; P <0.05). Conclusions: There is a dose-response effect for methadone treatment. Doses as low as 20 mg may improve retention but are inadequate for suppressing illicit drug use.

Original languageEnglish (US)
Pages (from-to)23-27
Number of pages5
JournalAnnals of Internal Medicine
Volume119
Issue number1
StatePublished - Jul 1 1993

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Methadone
Opioid Analgesics
Urine
Street Drugs
Cocaine
Therapeutics
Group Psychotherapy
Double-Blind Method
Counseling
Research
Population

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Dose-response effects of methadone in the treatment of opioid dependence. / Strain, Eric C; Stitzer, Maxine L; Liebson, Ira A.; Bigelow, George.

In: Annals of Internal Medicine, Vol. 119, No. 1, 01.07.1993, p. 23-27.

Research output: Contribution to journalArticle

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abstract = "Objective: To compare the dose effectiveness of low to moderate doses of methadone in a sample of a contemporary population of opioid abusers, because the optimal dosing of methadone in the treatment of opioid dependence remains an issue. Design: A randomized, double-blind, placebocontrolled study. Setting: A methadone treatment research clinic. Patients: Participants (n = 247) were opioid-dependent patients with a high rate of cocaine use. Intervention: All participants were initially treated with active methadone for a minimum of 5 weeks and then received 15 weeks of stable dosing at 50, 20, or 0 mg per day. Individual counseling and group therapy were included. Measurements: Treatment retention and illicit drug use as determined by intensive urine monitoring. Results: Retention was better for patients who remained on active medication. By treatment week 20, retention was 52.4{\%} for the 50-mg, 41.5{\%} for the 20-mg, and 21.0{\%} for the 0-mg group (50 versus 0 and 20 versus 0, P <0.05; 50 versus 20, P > 0.05). Only the 50-mg treatment group had a reduced rate of opioid-positive urine samples (56.4{\%} versus 67.6{\%} and 73.6{\%} for the 20-mg and 0-mg groups, respectively; P <0.05) and cocaine-positive urine samples (52.6{\%} versus 62.4{\%} and 67.1{\%} for the 20- and 0-mg groups, respectively; P <0.05). Conclusions: There is a dose-response effect for methadone treatment. Doses as low as 20 mg may improve retention but are inadequate for suppressing illicit drug use.",
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