Takoring Off Methadone: A Case Study

D- The patient arrived on time for her session and reports being stable on dose and haven't used any illicit drugs. This writer advised the patient that this writer was in fact in receipt of missed phone call about coming to the session at 10:30 am rather than 10 am due to her mother in the process of selling the house. This writer addressed with the patient about letter from CHR from her counselor, Jade Bray stating about the patient non-compliance with her appointment due transportation barrier. According to the patient, she is going through hardship as her mother is no longer taking her to her appointment as the patient says, " She's tired of bringing me everyone, Charlene. She complains about bringing me here and does not understand why I can't even get a bottle...:Like c'mon. What do I have to do?" This writer explained to the patient about TEAM decision, at which the patient disagree with the decision. This writer asked the patient about her "judgement." According to the patient, she feels she is making judgement by not engaging any further altercation with patient at the clinic, dosing daily, coming to her counseling session, and trying to get help from Chrysalis for

Currently in Ontario there are approximately 30,000 people, between the ages of 15 and 49, using illicit opioids on a regular basis. (Hart 2007) Opioid use is a costly and dangerous social problem and is the fastest growing drug problem in the country. The good news is that there is a treatment that has been proven by research and evidence to be effective. Methadone Maintenance Treatment (MMT) is a long term treatment program used to treat opioid dependence and addiction.(Source) MMT works by preventing withdrawal symptoms in opiate users. It also prevents the euphoria the user is seeking from other opiates. MMT uses the drug of Methadone to do this. Methadone is a synthetic opioid commonly used to treat opioid dependence.(Source)

America has a major problem with opioid addicts, and many facilities are helping the addicts by providing safer options to taking the drugs their bodies crave. Methadone clinics are places where people addicted to opioids can receive medicine-based therapy. Opioid use, drugs such as heroin, morphine, and prescribed painkillers, has increased in the US with all age groups and incomes. People become addicted to these drugs when they are prescribed, recreationally used with other addicts, or they are born addicted. Many health institutions are addressing this issue with an estimated 2.1 million people in the United States suffering from substance use disorders related to prescription opioid pain relievers in 2012 and an estimated 467,000 addicted

Methadone Maintenance Therapy (MMT) is used with opioid dependency and is an opioid replacement therapy. MMT typically replaces heroin with Methadone which is a cleaner substance than heroin, and is used to avoid withdrawal and allow the user to function normally within society. MMT has been around for the last 50 years, and research studies have been conducted to address the benefits and the complications associated with this replacement therapy. This paper will examine some of the advantages and disadvantages associated with MMT and reflect on personal ideals in accordance with MMT.

The roots of methadone were founded in Germany. In the 1930s, a team of German scientists produced the chemical structure of methadone, while searching for a pain-killing drug that would be less addictive than the commonly used pain medication morphine (University of Maryland, 2013, para. 2). Methadone was introduced to the United States in 1947 as a pain reliever for a variety of medical conditions (University of Maryland, 2013, para. 2). Shortly after the introduction of methadone into the United States, “Intravenous abuse of heroin intensified in New York City after World War II, and by the 1950s and 1960s, reached epidemic proportions” (Joseph, Stancliff, & Landgord, 2000, p. 347). The New York City death rate associated with injection

This writer met with the patient to address the conflicting issue with his medication. According to the patient, his PCP was prescribing him with his benzodiazepine medications; however, the patient says, " I had to seek a psychiatrist because it was only temporary." This explains the conflicting issues with the Rx Scripts on file. The patient started his treatment with his now psychatrist on 6/12/2017 and signed an ROI. Addressing picking up his medication from two different pharmacy, the patient was advise that he needs to be pick up his medication with only one pharmacy as it is required. The patient agreed to the terms and said, " I like CVS better than Walgreens. Sometimes they would my refill to Walgreens or whatever is closer to me,

69,000 patients in substance abuse treatment revealed that methadone was fourth for risk of abuse out of 11 opiate based prescription drugs. Worse, after adjustment for prescriptions, methadone advanced to the number one position for abused compounds. Even more startling was a simple random population sample, surveyed by telephone, which reported methadone as the second most used drug. However, Butler et al. cite a major limitation in that the data examined came from subjects who had entered treatment for substance use disorders. Like Plater et al. (2012) aside from the telephone survey, they were unable to examine data for abusers not in treatment (2011).

The purpose of this briefing memo is to provide recommendations to Council of City ABC on certain aspects it may or may not include in its zoning provisions with regard to methadone clinics and dispensaries. In the following sections I will provide my input on the provisions laid out by council.

Centers for Disease Control and Prevention (CDC) reported that there are about 100,000 of deaths per year and there are approximately 8 million people in United States who have substance abuse problem (CDC, 2015). A better understanding and greater attention to the commonly abused substance and its treatment would be beneficial in a providers practice and will also protect the provider from the legalities of prescribing these medications. There are several forms of treatment for every abused substance and the main goal is to help the patient to stop the stop and helping them during the phase of withdrawal. The intent of this paper is to discuss the commonly use substance for abuse

Besides preventing withdrawal, methadone treats the mom’s opioid addiction. About 70% of pregnant opioid addicts will relapse back to illicit opioid use (heroin or pain pills not prescribed to them) if they are taken off methadone. We also know that women enrolled in a methadone treatment program are much more likely to get prenatal care, and babies born to moms on methadone have higher birth weights than mothers in active addiction. If the mother is dosed with methadone, the baby is much less likely to be exposed to infectious agents like HIV and hepatitis from shared needle use. The baby also won’t be exposed to adulterants that can cause fetal damage, if heroin is being used.

Methadone is one of the most common medications used to treat opioid addiction. It decreases the symptoms of opioid withdrawal and inhibits the euphoric effects caused by abusing heroin and prescription opioids such as oxycodone. When used as prescribed and under the supervision of a trained physician, methadone is an effective complement to treatment. SAMHSA also recommends patients remain on methadone treatment for at least 12 months. Many people require multiple years of treatment. When discontinuing methadone treatment, patients should slowly taper off of it under doctor supervision. Buprenorphine decreases the potential for opioid abuse, reduces withdrawal symptoms and cravings and decreases the risks of overdose. Because buprenorphine

There were no Cochrane meta-analyses or systematic reviews for comparing methadone and Suboxone maintenance treatment head-to-head. There were 8 trials that had specific populations or were under-powered that I had difficulty choosing between. Before I tried deciding between these articles, I chose to search Medline for any more leads. After searching Medline, I found a rapid response report by the Canadian Agency for Drugs and Technologies in Health that compared Suboxone and methadone head-to-head. After looking into this review more, many of the trials I was considering choosing from Cochrane were included in the study, such as one by McKeganey, Russell, Cockayne (2013) which compared methadone and Suboxone in context of opioid

Pt. has been in the program for over 3 years and she is currently in Phase 0. Pt. has participated in the AMS of De methadone clinic, she has been able to achieve abstinence from illicit drugs but she is failing to comply with the mandatory counseling sessions. Pt. is now eligible to receive phase 1 take home privileges if she maintains satisfactory attendance and scheduled appointments. Pt. identified her children as a motivational factor to change and to reinforce the importance of remaining in recovery. Pt. was advised to obtain a sponsor and attend 12 Step meetings. Pt. has done in achieving her goal of maintaining financial compliance despite the holiday financial stress. Pt. seemed to accumulate a back balance, but normally pays for late account balance in full upon notice of an administrative taper.

Met with the patient as directed by the Clinical Director. According to the patient, he requested for a dose decrease of 1mgs per day until he reaches 0mgs. Based on the patient's order, he is indeed decreasing his methadone of 1mgs; however, the order stated that it will stop at 53mgs, not 0mgs. The patient informed this writer about a discussion he had with his assigned counselor Cherron about the importance of this due to the need to get off on the methadone as he wants to obtain his CDL but cannot do so if he is prescribed with methadone. This writer reviewed the patient's record and there are no AMA taper signed and no medical consultation documented. This writer then addresses this matter with the clinic's medical doctor, who was told

The purpose of the Standardized Methadone Wean Protocol for NAS is to initiate a standard treatment protocol for infants admitted to RNICU & CCN with a diagnosis of NAS that require pharmacological management of their symptoms. The process will begin by identifying those infants that require pharmacological management by accessing maternal history and Modified Finnegan Scores. A Modified Finnegan Score (see Appendix F) is a standardized scoring system such as the system developed by Finnegan and later modified by Jansson and others that is used to assess the signs and severity of withdrawal in infants (Finnegan, 2013; Finnegan, & Kaltenbach, 1992; & Jansson, Velez, & Harrow, 2009). RNICU & CNN use a modified version of the Finnegan