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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by Ilene Baker on August 6, 1998, at 18:38:40
Workig hard in a Methadone clinic. Is it appropriate to prescibe methadone and benzodiazepams.
what are other drugs that are contraindicated with methadone
Posted by Toby on August 13, 1998, at 15:21:46
In reply to methadone and benzo's - methadone and morphine , posted by Ilene Baker on August 6, 1998, at 18:38:40
There are no changes in methadone metabolism nor any increase in methadone-like subjective effects when patients on methadone are given low dose diazepam. In studies, patients have been given higher doses of diazepam in a dosing schedule approximating the pattern reported by patients who are abusing diazepam along with their methadone, and researchers found increases in subjective opioid effect scores and increases in phsyciologic measures like pupil constriction. Since there are no changes in metabolism rate, etc, these changes imply an interaction at the brain's receptor level.
Other drug interactions with methadone:
Tegretol -- lowers methadone blood levels and may lead to opiate withdrawal symptoms. When Tegretol is discontinued, methadone levels may rise, leading to toxicity.
Tricyclic antidepressants -- methadone may cause a rise in the blood level of the antidepressant.
Dilantin -- lowers methadone blood levels and may lead to opiate withdrawal symptoms. When Dilantin is discontinued, methadone levels may rise, leading to toxicity.
Smoking -- It has been noted that patients placed on methadone acutely increase the number of cigarettes smoked daily. However, when on maintenance, the number of cigarettes smoked returns to baseline.
Posted by TONDA on September 1, 1998, at 17:58:57
In reply to Re: methadone and benzo's - methadone and morphine , posted by Toby on August 13, 1998, at 15:21:46
> There are no changes in methadone metabolism nor any increase in methadone-like subjective effects when patients on methadone are given low dose diazepam. In studies, patients have been given higher doses of diazepam in a dosing schedule approximating the pattern reported by patients who are abusing diazepam along with their methadone, and researchers found increases in subjective opioid effect scores and increases in phsyciologic measures like pupil constriction. Since there are no changes in metabolism rate, etc, these changes imply an interaction at the brain's receptor level.
> Other drug interactions with methadone:
> Tegretol -- lowers methadone blood levels and may lead to opiate withdrawal symptoms. When Tegretol is discontinued, methadone levels may rise, leading to toxicity.
> Tricyclic antidepressants -- methadone may cause a rise in the blood level of the antidepressant.
> Dilantin -- lowers methadone blood levels and may lead to opiate withdrawal symptoms. When Dilantin is discontinued, methadone levels may rise, leading to toxicity.
> Smoking -- It has been noted that patients placed on methadone acutely increase the number of cigarettes smoked daily. However, when on maintenance, the number of cigarettes smoked returns to baseline.i AM SEEKING INFORMATION ON PRESCRIBING BENZOS TO THE ADDICT WHO IS ATTEMPTING TO FIND RECOVERY. ANY HELP? ANY ARTICLES AVAILABLE?
Posted by Charles Pride on July 17, 2000, at 22:53:49
In reply to Re: methadone and benzo's - methadone and morphine , posted by TONDA on September 1, 1998, at 17:58:57
I am searching for information reagarding how to differeniate between methadone and heroin in urine toxicology results.
Posted by shar on July 28, 2000, at 20:54:55
In reply to How to differeniate between heroin methadone , posted by Charles Pride on July 17, 2000, at 22:53:49
I don't know anything about this topic, and haven't seen it discussed here at PB.
However, using Infoseek, I did a search on "drug testing" and then within that "heroin" and found several sites that might help you. One is www.atilab.com/index.html and they have a newsletter article on heroin testing in urine vs. hair and how heroin is detected. There is also a contact on the home page for technical questions. You could try asking them your question.
As a last ditch effort you could replicate the search I did, and do one more search within the heroin group for methadone. Or do an advanced search where both heroin and methadone have to be present, plus drug testing or urine testing or urinalysis.
Good luck,
Shar
> I am searching for information reagarding how to differeniate between methadone and heroin in urine toxicology results.
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