Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine
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 betw...
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doaj-a39d9c32c2cb45b9a2346b1a11886f262020-11-25T02:16:44ZengBMCBMC Psychiatry1471-244X2017-07-0117111110.1186/s12888-017-1415-yPolydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicinePertti Kalevi Heikman0Leea Hellevi Muhonen1Ilkka Antero Ojanperä2University of Helsinki and Helsinki University Central Hospital, PsychiatryUniversity of Helsinki and Helsinki University Central Hospital, PsychiatryUniversity of Helsinki, Forensic MedicineAbstract 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.http://link.springer.com/article/10.1186/s12888-017-1415-yOpioid maintenance treatmentPolydrug abuseDoseDrug screeningTime-of-flight mass spectrometry |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Pertti Kalevi Heikman Leea Hellevi Muhonen Ilkka Antero Ojanperä |
spellingShingle |
Pertti Kalevi Heikman Leea Hellevi Muhonen Ilkka Antero Ojanperä Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine BMC Psychiatry Opioid maintenance treatment Polydrug abuse Dose Drug screening Time-of-flight mass spectrometry |
author_facet |
Pertti Kalevi Heikman Leea Hellevi Muhonen Ilkka Antero Ojanperä |
author_sort |
Pertti Kalevi Heikman |
title |
Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
title_short |
Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
title_full |
Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
title_fullStr |
Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
title_full_unstemmed |
Polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
title_sort |
polydrug abuse among opioid maintenance treatment patients is related to inadequate dose of maintenance treatment medicine |
publisher |
BMC |
series |
BMC Psychiatry |
issn |
1471-244X |
publishDate |
2017-07-01 |
description |
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. |
topic |
Opioid maintenance treatment Polydrug abuse Dose Drug screening Time-of-flight mass spectrometry |
url |
http://link.springer.com/article/10.1186/s12888-017-1415-y |
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