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Patients in methadone maintenance programs use benzodiazepines to "boost" methadone's subjective effects, and flunitrazepam has been prominent in this context. Self-administration of flunitrazepam (0.001-0.32 mg/kg i.v.) alone and during daily oral methadone administration was evaluated in three baboons. Flunitrazepam maintained self-injection as an inverted U-shaped function of dose at rates higher than those maintained by most other benzodiazepines under the same procedure. In the context of demonstrated physical dependence on 3.2 mg/kg/day p.o. methadone, flunitrazepam doses on the ascending limb of the dose-effect curve maintained greater rates of self-injection than before methadone in two baboons. When the methadone dose decreased to 1.8 mg/kg/day, self-injection remained higher for those baboons and became higher than before methadone for the third baboon. Self-injection remained higher when methadone decreased to 1.0 mg/kg/day, except self-injection of the lowest flunitrazepam dose returned to or below the pre-methadone rate for two baboons. After methadone was discontinued, the dose-effect curve shifted to the right in one baboon but remained to the left in two. Flunitrazepam thus served as a reinforcer alone and in the context of methadone maintenance. Lower doses maintained higher self-injection during and shortly after methadone maintenance. Further research should explore the duration of higher self-injection rates following methadone maintenance.
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http://dx.doi.org/10.1016/j.drugalcdep.2004.09.007 | DOI Listing |
BMJ Public Health
August 2025
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Introduction: Hepatitis C virus (HCV) infection is a substantial public health concern, particularly among individuals with opioid addiction. The methadone maintenance treatment (MMT) programmes serve as a harm reduction strategy to mitigate HIV disease spread, yet the risk of HCV infection remains high within these settings. Accurate risk prediction for HCV seroconversion is therefore crucial for improving patient outcomes.
View Article and Find Full Text PDFIndian J Psychiatry
August 2025
National Drug Dependence Treatment Centre, AIIMS, New Delhi, India.
Perinatal opioid use is the major public health concern worldwide due to its hazardous effect on the mother and the developing fetus. Opioid agonist maintenance treatment with buprenorphine or methadone has been the recommended treatment for opioid dependence during pregnancy for various reasons. There is scarcity of literature in this regard.
View Article and Find Full Text PDFJ Res Pharm Pract
August 2025
Cardiovascular Research Center, Institute of Basic and Clinical Physiology Sciences, Kerman University of Medical Sciences, Kerman, Iran.
Objective: Methadone treatment is effective for managing opioid use disorder (OUD) but raises concerns about its impact on cardiac function. This study aimed to assess the prevalence of cardiac dysfunction among individuals under methadone treatment.
Methods: This cross-sectional study involved 200 OUD patients admitted to addiction treatment centers of Kerman, Iran, who were at least 1 year under methadone maintenance therapy.
Health Aff (Millwood)
September 2025
Paul J. Joudrey, University of Pittsburgh.
State regulations governing opioid treatment programs (OTPs) vary widely in their restrictiveness, but how they affect geographic access to methadone maintenance treatment for opioid use disorder remains poorly understood. In this study of comprehensive data on methadone shipments to OTPs in 2019, we found that ZIP codes just across the border in states with low restrictiveness in OTP regulations had more than twice the OTP density and methadone shipments compared with nearby and otherwise similar ZIP codes in states with high restrictiveness. These findings suggest that restrictive state OTP regulations constrain geographic access to methadone maintenance treatment and that easing such restrictions is a viable strategy to expand access.
View Article and Find Full Text PDFInt J Obstet Anesth
July 2025
Department of Anesthesiology, University of Florida - Jacksonville, Jacksonville, FL, USA. Electronic address:
Background: Scheduled multimodal non-opioid analgesics after cesarean delivery are effective in reducing opioid consumption. However, there is limited information regarding the effectiveness of this practice for reducing opioid consumption in patients on opioid agonists (methadone or buprenorphine) for an opioid use disorder. We hypothesized that standardized neuraxial anesthesia with neuraxial morphine and multimodal non-opioid analgesics would result in similar postoperative opioid consumption between patients on opioid agonist therapy and opioid-naïve controls.
View Article and Find Full Text PDF