Methadone and metabolite urine concentrations in patients maintained on methadone

Kenzie L. Preston, David H. Epstein, David Davoudzadeh, Marilyn A. Huestis

Research output: Contribution to journalArticle

Abstract

As regulatory control over methadone maintenance relaxes, the need for methods of monitoring compliance will increase. In community clinics, monitoring would most likely involve immunoassays of outpatients' trough urine specimens. There are no published norms for such data. Therefore, we determined concentrations of methadone in 1093 urine specimens collected thrice weekly in 27 outpatients during up to 17 weeks of observed methadone ingestion (35 to 80 mg/day) using a semiquantitative homogeneous enzyme immunoassay (CEDIA). We used a separate CEDIA assay to measure methadone's main metabolite, 2-ethylidene-3,3-diphenylpyrrolidine (EDDP), which may help detect compliance in fast metabolizers or patients who adulterate samples to simulate compliance. Methadone concentrations were more variable than those of EDDP. Concentrations of methadone were <100 ng/mL in one specimen, between 100 and 300 ng/mL in 27, and ≥ 300 ng/mL in all others. EDPP concentrations were ≥ 100 ng/mL in all specimens, suggesting that EDDP should be detectable in urine from compliant patients. Methadone and EDDP concentrations significantly increased with methadone dose and (in one participant with poor clinic attendance) significantly decreased following missed methadone doses. Nevertheless, variability was too great to permit estimation of methadone dose (or detect a single missed administration) from any single specimen.

Original languageEnglish (US)
Pages (from-to)332-341
Number of pages10
JournalJournal of Analytical Toxicology
Volume27
Issue number6
StatePublished - Sep 2003
Externally publishedYes

Fingerprint

Methadone
Metabolites
urine
compliance
metabolite
immunoassay
Urine
Monitoring
monitoring
Assays
Compliance
trough
Enzymes
assay
enzyme
Outpatients
dose
Immunoenzyme Techniques
Immunoassay
Eating

ASJC Scopus subject areas

  • Analytical Chemistry
  • Toxicology
  • Health, Toxicology and Mutagenesis

Cite this

Preston, K. L., Epstein, D. H., Davoudzadeh, D., & Huestis, M. A. (2003). Methadone and metabolite urine concentrations in patients maintained on methadone. Journal of Analytical Toxicology, 27(6), 332-341.

Methadone and metabolite urine concentrations in patients maintained on methadone. / Preston, Kenzie L.; Epstein, David H.; Davoudzadeh, David; Huestis, Marilyn A.

In: Journal of Analytical Toxicology, Vol. 27, No. 6, 09.2003, p. 332-341.

Research output: Contribution to journalArticle

Preston, KL, Epstein, DH, Davoudzadeh, D & Huestis, MA 2003, 'Methadone and metabolite urine concentrations in patients maintained on methadone', Journal of Analytical Toxicology, vol. 27, no. 6, pp. 332-341.
Preston KL, Epstein DH, Davoudzadeh D, Huestis MA. Methadone and metabolite urine concentrations in patients maintained on methadone. Journal of Analytical Toxicology. 2003 Sep;27(6):332-341.
Preston, Kenzie L. ; Epstein, David H. ; Davoudzadeh, David ; Huestis, Marilyn A. / Methadone and metabolite urine concentrations in patients maintained on methadone. In: Journal of Analytical Toxicology. 2003 ; Vol. 27, No. 6. pp. 332-341.
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