Pharmacotherapy in the Treatment of Addiction: Methadone
Open accessAbstract
Methadone maintenance treatment (MMT) is the most widely available pharmacotherapy for opioid addiction and has been shown to be an effective and safe treatment over a period of 40 years. Although women comprise approximately 40% of clients currently being treated in MMT programs, comparatively little research geared specifically toward this group has been published. This article begins with an overview of neurobiological studies on opioid addiction, including a discussion of gender differences, followed by a review of the pharmacology of methadone. The authors then examine the particular needs and differences of women being treated in MMTs, including co-dependence with other substances, women's health issues, and psychosocial needs unique to this population. Research shows that women have different substance abuse treatment needs in comparison to their male counterparts. One New York City MMT program that has attempted to address these differences is highlighted.
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Higher doses (>80 mg/day) of methadone are associated with better outcomes than lower doses.
“Higher doses (>80 mg/day) are associated with better outcomes than lower doses 190 .”
From Substance use disorders: a comprehensive update of classification, epidemiology, neurobiology, clinical aspects, treatment and prevention (2023) · cites this paper as [190]
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Brady, T. M., Salvucci, S., Sverdlov, L., Male, A., Kyeyune, H., Sikali, E., Desale, S. Y., & Yu, P. (2005) · Journal of Addictive Diseases · doi:10.1300/j069v24n03_03 · Cited by 48 · see citing works
Retention and illicit drug use among methadone patients in Israel: A gender comparison
Schiff, M., Levit, S., & Cohen-Moreno, R. (2007) · Addictive Behaviors · doi:10.1016/j.addbeh.2007.01.010 · Cited by 48 · see citing works
Factors affecting the outcome of methadone maintenance treatment in opiate dependence.
Kamal, F., Flavin, S., Campbell, F., et al. (2007) · PubMed · Cited by 47 · see citing works
Methadone—Disulfiram Interaction During Methadone Maintenance
Tong, T. G., Benowitz, N. L., & Kreek, M. J. (1980) · The Journal of Clinical Pharmacology · doi:10.1002/j.1552-4604.1980.tb02543.x · Cited by 46 · see citing works
Self-citationDm, N., Khan, I., & Mj, K. (1986) · PubMed · Cited by 46 · see citing works
Crack cocaine use in a cohort of methadone maintenance patients
Des Jarlais Don, C., Wenston, J., Friedman, S. R., et al. (1992) · Journal of Substance Abuse Treatment · doi:10.1016/0740-5472(92)90025-j · Cited by 45 · see citing works
Tennant, F. S., & Shannon, J. A. (1995) · Journal of Addictive Diseases · doi:10.1300/j069v14n01_07 · Cited by 41 · see citing works
Hepatic Extraction of Long- and Short-Acting Narcotics in the Isolated Perfused Rabbit Liver
Kreek, M. J., Oratz, M., & Rothschild, M. A. (1978) · Gastroenterology · doi:10.1016/0016-5085(78)93770-8 · Cited by 40 · see citing works
Self-citationHiltunen, A. J., Beck, O., Hjemdahl, P., et al. (1999) · Psychopharmacology · doi:10.1007/s002130050963 · Cited by 38 · see citing works
Bart, G. B., LaForge, K. S., Borg, L., Lilly, C., Ho, A., & Kreek, M. J. (2006) · Neuropsychopharmacology · doi:10.1038/sj.npp.1301128 · Cited by 38 · see citing works
Self-citationSuccessful treatment of 750 criminal addicts
Dole, V. P. (1968) · JAMA · doi:10.1001/jama.206.12.2708 · Cited by 37 · see citing works
Branstetter, S. A., Bower, E. H., Kamien, J., & Amass, L. (2008) · Journal of Substance Abuse Treatment · doi:10.1016/j.jsat.2007.03.009 · Cited by 36 · see citing works
Oosterhuis, B. E., LaForge, K. S., Proudnikov, D., Ho, A., Nielsen, D. A., Gianotti, R. J., Barral, S., Gordon, D., Leal, S. M., Ott, J., et al. (2008) · American Journal of Medical Genetics Part B Neuropsychiatric Genetics · doi:10.1002/ajmg.b.30716 · Cited by 36 · see citing works
Self-citationBailey, A., Gianotti, R. J., Ho, A., & Kreek, M. J. (2005) · Synapse · doi:10.1002/syn.20168 · Cited by 35 · see citing works
Self-citationGender Differences and Pregnant Women in a Methadone Maintenance Treatment (MMT) Clinic
Peles, E., & Adelson, M. (2006) · Journal of Addictive Diseases · doi:10.1300/j069v25n02_06 · Cited by 35 · see citing works
Caetano, R., Nelson, S. M., & Cunradi, C. B. (2001) · American Journal on Addictions · doi:10.1080/10550490190942524 · Cited by 35 · see citing works
Sulkowski, M., Wright, T. L., Rossi, S., Arora, S., Lamb, M. W., Wang, K., Gries, J., & Yalamanchili, S. (2005) · Clinical Pharmacology & Therapeutics · doi:10.1016/j.clpt.2004.09.008 · Cited by 34 · see citing works
Kreek, M. J., Schlussman, S. D., Bart, G. B., LaForge, K. S., & Butelman, E. R. (2004) · Neuropharmacology · doi:10.1016/j.neuropharm.2004.07.024 · Cited by 34 · see citing works
Self-citationKreek, M. J., Bencsath, F. A., & Field, F. H. (1980) · Biological Mass Spectrometry · doi:10.1002/bms.1200070906 · Cited by 33 · see citing works
Self-citationUrine Screening for Marijuana Among Methadone‐Maintained Patients
Saxon, A. J., Calsyn, D. A., Greenberg, D. M., et al. (1993) · American Journal on Addictions · doi:10.1111/j.1521-0391.1993.tb00421.x · Cited by 31 · see citing works
Hachey, D. L., Kreek, M. J., & Mattson, D. H. (1977) · Journal of Pharmaceutical Sciences · doi:10.1002/jps.2600661120 · Cited by 31 · see citing works
Self-citationDrug-related menstrual aberrations.
Bai, J., Greenwald, E., Caterini, H., et al. (1974) · PubMed · Cited by 30 · see citing works
Cannabis versus other illicit drug use among methadone maintenance patients.
Nirenberg, T. D., Cellucci, T. J., Liepman, M. R., et al. (1996) · Psychology of Addictive Behaviors · doi:10.1037/0893-164x.10.4.222 · Cited by 29 · see citing works
Bidirectional translational research: Progress in understanding addictive diseases
Kreek, M. J., Schlussman, S. D., Reed, B., Zhang, Y., Nielsen, D. A., Levran, O., Zhou, Y., & Butelman, E. R. (2008) · Neuropharmacology · doi:10.1016/j.neuropharm.2008.07.042 · Cited by 28 · see citing works
Self-citationClinical review 77: evaluation of secondary amenorrhea.
Warren, M. P. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jcem.81.2.8636244 · Cited by 27 · see citing works
Contraceptive practice of women with opiate addiction in a rural centre
Harding, C., & Ritchie, J. (2003) · Australian Journal of Rural Health · doi:10.1046/j.1440-1584.2003.00477.x · Cited by 26 · see citing works
Novick, D. M., Stenger, R. J., Gelb, A. M., Most, J., Yancovitz, S. R., & Kreek, M. J. (1986) · Alcoholism Clinical and Experimental Research · doi:10.1111/j.1530-0277.1986.tb05131.x · Cited by 26 · see citing works
Self-citationAvailability of Reliable Serum Methadone Determination for Management of Symptomatic Patients
Borg, L., Ho, A., PETERS, J. E., et al. (1995) · Journal of Addictive Diseases · doi:10.1300/j069v14n03_06 · Cited by 25 · see citing works
Self-citationRole of a Functional Human Gene Polymorphism in Stress Responsivity and Addictions
Mj, K. (2008) · Clinical Pharmacology & Therapeutics · doi:10.1038/clpt.2008.5 · Cited by 24 · see citing works
Ethanol and methadone in man: A possible drug interaction
Cushman, P., Kreek, M. J., & Gordis, E. (1978) · Drug and Alcohol Dependence · doi:10.1016/0376-8716(78)90033-9 · Cited by 24 · see citing works
Self-citationBrief screening for co-occurring disorders among women entering substance abuse treatment
Lincoln, A. K., Liebschutz, J. M., Chernoff, M., Nguyen, D. R., & Amaro, H. D. L. A. (2006) · Substance Abuse Treatment Prevention and Policy · doi:10.1186/1747-597x-1-26 · Cited by 24 · see citing works
Progress to Achieve Balanced State Policy Relevant to Pain Management and Palliative Care
Gilson, A. M., Joranson, D. E., Maurer, M. A., Ryan, K. M., & Garthwaite, J. P. (2005) · Journal of Pain & Palliative Care Pharmacotherapy · doi:10.1080/j354v19n01_05 · Cited by 24 · see citing works
28. Methadone maintenance and its implication for theories of narcotic addiction.
Dole, V. P., & Nyswander, M. E. (1968) · PubMed · Cited by 24 · see citing works
Methadone Metabolism by Early Gestational Age Placentas
Hieronymus, T., Nanovskaya, T. N., Deshmukh, S. V., et al. (2006) · American Journal of Perinatology · doi:10.1055/s-2006-947160 · Cited by 23 · see citing works
Berk, S. I., Litwin, A. H., Arnsten, J. H., Du, E. Y., Soloway, I. J., & Gourevitch, M. N. (2007) · Clinical Therapeutics · doi:10.1016/j.clinthera.2007.01.009 · Cited by 23 · see citing works
Fordyce, E. J., Blum, S., Balanon, A., et al. (1991) · American Journal of Epidemiology · doi:10.1093/oxfordjournals.aje.a115931 · Cited by 23 · see citing works
Tolerance and dependence: implications for the pharmacological treatment of addiction.
Kreek, M. J. (1987) · PubMed · Cited by 22 · see citing works
Self-citationGupta, S. K., Sellers, E. M., Somoza, E. C., Angles, L., Kolz, K., & Cutler, D. L. (2007) · The Journal of Clinical Pharmacology · doi:10.1177/0091270007299760 · Cited by 22 · see citing works
Exploring the Prevalence of Menopause Symptoms in Midlife Women in Methadone Maintenance Treatment
Tuchman, E. (2007) · Social Work in Health Care · doi:10.1300/j010v45n04_03 · Cited by 21 · see citing works
Deren, S., Kang, S.-Y., Colón, H. M., et al. (2007) · The American Journal of Drug and Alcohol Abuse · doi:10.1080/00952990601175037 · Cited by 20 · see citing works
Biliary secretion of methadone and methadone metabolites in man.
Kreek, M. J., Kalisman, M., Irwin, M. G., et al. (1980) · PubMed · Cited by 20 · see citing works
Self-citationFemale Sexual Health Problems in a Drug Dependency Unit
Morrison, C. L., Ruben, S. M., & Beeching, N. J. (1995) · International Journal of STD & AIDS · doi:10.1177/095646249500600311 · Cited by 18 · see citing works
Perceived Causal and Treatment Factors Related to Substance Abuse: Gender Differences
Lev‐Wiesel, R., & Shuval, R. (2006) · European Addiction Research · doi:10.1159/000090431 · Cited by 16 · see citing works
Clinical review 77: evaluation of secondary amenorrhea
Warren, M. P. (1996) · The Journal of Clinical Endocrinology & Metabolism · doi:10.1210/jc.81.2.437 · Cited by 12 · see citing works
Opioid Disposition and Effects During Chronic Exposure in the Perinatal Period in Man
Kreek, M. J. (1982) · Advances in Alcohol & Substance Abuse · doi:10.1300/j251v01n03_03 · Cited by 9 · see citing works
Self-citationFecal excretion of methadone and its metabolites in man : applications of GC-MS
Bowen, D., Smit, A. A., & Mj, K. (1976) · TU/e Research Portal · Cited by 7 · see citing works
Dole, V. P. (1971) · Springer eBooks · doi:10.1007/978-1-4684-1869-9_25 · Cited by 4 · see citing works
Changes in methadone pharmacokinetics during pregnancy
Pond, S. M., Kreek, M. J., Tong, T. G., & Benowitz, N. L. (1982) · Clinical research · Cited by 4 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- [5]Kreek MJ The role of qualitative and quantitative analysis of drugs and their metabolites in maternal-neonatal studies National Institute on Drug Abuse Symposium on Comprehensive Health Care for Addicted Families and Their Children 1977 Washington, DC Services Research Report (USGPO) 67 73 #017-024-00598-3
- [75]Kleinschmidt KC Wainscott M Ford MD Ford MD Delaney KA Ling LJ Erickson T Opioids Ford: clinical toxicology 2001 1st Ed. Philadelphia WB Saunders 627 639
Cited by
Sorted by citations
Volkow, N. D., & Blanco, C. (2023) · World psychiatry · doi:10.1002/wps.21073 · Cited by 503 · see citing works
Brigham, G. S., Slesnick, N., Winhusen, T. M., Lewis, D. F., Guo, X., & Somoza, E. (2014) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2014.02.013 · Cited by 59 · see citing works
- Authors
- Kreek, M. J., Borg, L., Ducat, E., & Ray, B.
- Affiliations
- Rockefeller University (US)
- ORCID
- Kreek, Mary Jeanne
- Venue
- Journal of Addictive Diseases
- Publisher
- Informa UK Limited
- Published
- 2010-04-16
- Volume
- 29
- Issue
- 2
- Pages
- 200-216
- ISSN
- 1055-0887 (ISSN-L)
- 1545-0848
- PMC
- PMC2885886
- OpenAlex
- W2103431332
- Cited by
- 108
- References
- 155
- Citations by year
- 2026: 5 · 2025: 5 · 2024: 2 · 2023: 4 · 2022: 4 · 2021: 12 · 2020: 5 · 2019: 10 · 2018: 6 · 2017: 8 · 2016: 6 · 2015: 10 · 2014: 9 · 2013: 6 · 2012: 8
- FWCI
- 7.00
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Addictive Diseases (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (MH79880, R01MH079880)
- National Institute on Drug Abuse (P50DA005130, P60 DA 05130, P60DA005130)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- methadone maintenance treatment, opioid use disorder, women, gender differences, opioid pharmacology, codependency, women's health, psychosocial needs, addiction treatment
- MeSH terms
- Analgesics, Opioid, Attitude to Health, Female, Heroin Dependence, Humans, Methadone, Surveys and Questionnaires, Behavior, Addictive, Treatment Outcome
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