Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine

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Heikman , P K , Muhonen , L H & Ojanpera , I A 2017 , ' Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine ' , BMC Psychiatry , vol. 17 , 245 . https://doi.org/10.1186/s12888-017-1415-y

Title: Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine
Author: Heikman, Pertti Kalevi; Muhonen, Leea Hellevi; Ojanpera, Ilkka Antero
Contributor: University of Helsinki, University of Helsinki
University of Helsinki, Medicum
Date: 2017-07-06
Language: eng
Number of pages: 11
Belongs to series: BMC Psychiatry
ISSN: 1471-244X
URI: http://hdl.handle.net/10138/207004
Abstract: Background: Polydrug abuse is a known problem among opioid-dependent patients receiving opioid maintenance treatment (OMT). However, improved laboratory diagnostics is required to reveal polydrug abuse in its current scope. Furthermore, there are few studies focusing on the relationship between polydrug abuse and adequacy of the dose of OMT medicine. This study aimed to evaluate the polydrug abuse among opioid-dependent patients receiving OMT with inadequate (Group IA) and adequate (Group A) doses of OMT medicine as experienced by the patients. Craving for opioids and withdrawal symptoms were evaluated as indicators of the adequacy rating. Methods: This is a retrospective register-based study of 60 OMT patients on either methadone or sublingual buprenorphine/naloxone medication, whose polydrug abuse was studied from urine samples by means of a comprehensive high-resolution mass spectrometry method. Results: Inadequate doses of the OMT medicines were associated with higher subjective withdrawal scores and craving for opioids. Six groups of abused substances (benzodiazepines, amphetamines, opioids, cannabis, new psychoactive substances, and non-prescribed psychotropic medicines) were found among OMT patients. Group IA patients showed significantly more abuse of benzodiazepines and amphetamines than the Group A patients. All the new psychoactive substances and most of the non-prescribed psychotropic medicines were detected from the Group IA patients. There was no difference in the doses of the OMT medicine between Groups IA and A patients. Conclusions: Polydrug abuse, detected by definitive laboratory methods, was widespread and more common among Group IA than Group A patients, emphasizing the requirement for individual OMT medicine dose adjustment.
Subject: Opioid maintenance treatment
Polydrug abuse
Dose
Drug screening
Time-of-flight mass spectrometry
MASS-SPECTROMETRY
DRUG-USE
PSYCHOACTIVE SUBSTANCES
BUPRENORPHINE-NALOXONE
METHADONE
DEPENDENCE
URINE
THERAPY
MISUSE
QUETIAPINE
3124 Neurology and psychiatry
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