HPLC法测定盐酸美沙酮含量

本文采用高效液相色谱法，以盐酸布比卡因为内标，检测波长220nm，在Symmetry-C18柱上，以己腈-磷酸二氢钾（pH2．5）（3862，V／V）为流动相，测定盐酸美沙酮及其口服液的含量。方法平均回收率为100．17％，日内及日间的RSD均＜1％。方法简便、快速、准确。     

Antisocial personality disorder, HIV risk behavior and retention in methadone maintenance therapy

In a sample of 55 consecutive methadone maintenance admissions to our clinic, 42% were diagnosed with antisocial personality disorder (ASPD) using the National Institute of Mental Health Diagnostic Interview Schedule NIMH DIS. Individuals with ASPD exhibited greater risk for HIV infection as defined by more sexual contacts, needle use and equipment sharing. Data at 1 year follow-up were obtained on this group of patients. The objective was to compare the ASPD and non-ASPD groups with regards to demographics, drug abuse history, outcome and retention in treatment. There were no significant differences between the groups on any demographic or treatment outcome variables. Survival analysis indicated that there were no group differences in treatment retention. In conclusion, although there were no differences in treatment outcome between ASPD and non-ASPD groups it is possible that ASPD patients who drop out of treatment will be at higher risk for contracting and spreading HIV within the IV drug using population. These data also suggest that in this population the diagnosis of ASPD using primarily behavioral traits as measured in the NIMH-DIS-III, has little utility in predicting treatment outcome.     

A comparison of the effects of a macrobiotic diet and a western diet on drug metabolism and plasma lipids in man

Summary We have compared the effects of two dietary regimens with different macronutrient compositions — a macrobiotic diet and a Western diet — on drug metabolism and plasma lipids in seven healthy volunteers.The macrobiotic diet, high in carbohydrate, low in protein and fat, and devoid of animal food sources, was eaten for a ten day control period, as was the Western diet, high in calories, fat, and protein, as well as animal food sources. We determined the influences of these diets on the clearance of orally administered antipyrine, oxazepam, and methadone, as well as on plasma lipids.There was a statistically significant change in antipyrine clearance as well as in plasma LDL-cholesterol and HDL-cholesterol after the dietary periods. This suggests that the influence of dietary changes may have some effect on the clearance of therapeutic drugs. However, this is not universal and is probably important when the drug is highly dependent on the mixed-function oxidase system.     

Bridges and barriers to recovery: Clinical observations from an opiate recovery project

Clinical issues are described in opiate addicts attempting to taper off methadone maintenance, and techniques are suggested to help this patient population. The observations were generated in an experimental “Tapering Network” project, in which opiate addicts on methadone maintenance had the opportunity to receive individual and group counseling, relapse prevention training, self-help groups, and other services. Vignettes illustrate clinical problems with intimacy and social isolation, identity as a former addict, and a “post methadone syndrome” characterized by vulnerability, dramatic swings in mood, and disordered thinking for a period of up to six months after detoxification. To counteract these barriers to recovery, a program model is suggested that uses curricula available in the emerging literature on treatment of substance abuse. These techniques can provide bridges to recovery.     

Unusual Cause of Methadone Poisoning

ABSTRACT. A child with respiratory distress was found to have been given an antibiotic which was reconstituted with methadone. A delay in standard emergency room management led to a delay in diagnosis and treatment.     

二氢埃托啡对吗啡依赖大鼠和猴的实验治疗

二氢埃托啡(DHE)能明显缓解吗啡依赖大鼠和猴用纳洛酮(Nal)催促或停用吗啡后出现的戒断症状,DHE对吗啡依赖猴替代治疗的疗效与美沙酮(Met)相当,经9d替代治疗,Met替代组动物Nal催促后仍出现一定的戒断症状,而DHE替代组动物未见戒断症状.     

A comparison of residential heroin detoxification patients and methadone maintenance patients

Interviews were conducted with 101 heroin dependent persons entering a residential drug-free detoxification unit in 1989. These self-report data were compared with those previously collected in 1985-6 from 457 methadone maintenance patients. The detoxification patients injected less frequently, used less heroin, had been physically dependent for a shorter period and were more likely to be single, unemployed and to have been charged with a criminal offence in the last 12 months. It is suggested that these findings may indicate that addicts who use more heroin are less likely to seek drug-free detoxification. The wider implication of the finding is that future surveys of injecting drug users should assume that there are significant differences between heroin users entering different modalities of treatment.     

Pharmacological options for management of opioid dependence

Methadone is currently the only opioid available for the pharmacotherapy of opioid dependence. Cross-tolerance between methadone and other opioids constitutes the pharmacological basis for substitution and attenuating the effects of illicit opioid use. However, these principles limit the utility of methadone. Potential alternative opioids include long-acting partial agonists such as buprenorphine and pure antagonists such as naltrexone. Buprenorphine is an alternative to methadone with intermediate intrinsic efficacy. It has a large margin of safety, yet displays some agonist actions similar to methadone. It has greater potential than methadone to safely and effectively block the actions of illicit opioids. Naltrexone is a safe, convenient opioid-antagonist for use following detoxification from opioid agonists. Its main use is to block the actions of other opioids, thereby attenuating or eliminating illicit use during treatment. However, it is poorly accepted by many clients, limiting its application to a sub-group who are highly motivated to detoxify. The distinct pharmacological properties of these opioids can overcome some of the drawbacks of methadone, but other limitations may emerge. Non-opioid adjuncts such as alpha2-adrenoceptor agonists can also have a role during detoxification. These drugs might be of use for specific groups of opioid users, providing therapists with the flexibility to tailor pharmacotherapy to the individual needs of clients.     

Improvements in retention rates and changes in client group with methadone maintenance streaming

This study evaluated changes in client population and in retention rates following the introduction of a system of methadone maintenance streaming. A low intervention and low supervision stream was combined with two abstinence-orientated streams. Privileges of take-home doses and local pharmacy dose collection were contingent on successful participation in the abstinence-orientated streams. The clinic also modified policy to allow clients greater control over dose levels. The case notes of the first 100 clients entering the programme in the year prior to the changes (1991) and in the year following the changes (1993) were compared. The results showed a significant increase in retention rates. The demographic and heroin using histories did not change, but the newer programme attracted a greater proportion of clients with no previous history of methadone maintenance treatment. Mean clinic dose increased from 45 mg to 63 mg when clients were allowed to exert control over dose. These findings reveal improved outcomes in a public methadone maintenance programme as a result of policy changes designed to give clients greater control of their treatment.