Neuronal Aspects of Opiate Dependence and Tolerance in Comparison to Central Depressants

A 40-year-old patient was admitted through the acute medical take with pleuritic chest pain and rigours. He had a medical history of opiate dependence and was receiving 60 mg of methadone once daily. He was diagnosed with a community-acquired pneumonia and treated with amoxicillin and clarithromycin. After administration of only two concomitant doses of methadone and oral clarithromycin, he developed an opioid toxidrome with type-2 respiratory failure, a decreased level of consciousness and pinpoint pupils. The patient was treated with naloxone and his symptoms improved. Retrospectively, it was suspected that an interaction between clarithromycin and methadone might have contributed to the toxidrome. Respiratory failure has not been previously prescribed for this combination of medication and is of high importance for physicians and pharmacists around the world.

Download Full-text

Effect of craving induction on inhibitory control in opiate dependence

Psychopharmacology ◽

10.1007/s00213-011-2512-0 ◽

2011 ◽

Vol 219 (2) ◽

pp. 519-526 ◽

Cited By ~ 13

Author(s):

Antonio Verdejo-García ◽

Dan I. Lubman ◽

Anne Schwerk ◽

Kim Roffel ◽

Raquel Vilar-López ◽

...

Keyword(s):

Inhibitory Control ◽

Opiate Dependence

Download Full-text

Levomethadyl in Maintenance Treatment of Opiate Dependence

JAMA ◽

10.1001/jama.1972.03200060039005 ◽

1972 ◽

Vol 220 (6) ◽

pp. 811 ◽

Cited By ~ 34

Author(s):

Arthur Zaks

Keyword(s):

Maintenance Treatment ◽

Opiate Dependence

Download Full-text

Opiate dependence and pregnancy: 20-year follow-up study

Psychiatric Bulletin ◽

10.1192/pb.bp.106.011585 ◽

2007 ◽

Vol 31 (12) ◽

pp. 450-453 ◽

Cited By ~ 2

Author(s):

Marie Whitty ◽

John O'Connor

Keyword(s):

Psychosocial Functioning ◽

Substance Misuse ◽

Opiate Dependence ◽

Drug Misuse ◽

Clinical Implications ◽

Follow Up Study ◽

Treatment Centre ◽

Long Term Follow Up

AIMS AND METHODThis study examined the 20-year outcome of 55 women who were pregnant and using opiates in 1985 and were attending the Drug Treatment Centre and Advisory Board, Dublin. We established outcome across a number of variables, including mortality, psychiatric and physical morbidity, psychosocial functioning, ongoing drug misuse and outcome of offspring.RESULTSAt 20-year follow-up 29 women (53%) were deceased. HIV was the commonest cause of death, accounting for 17 deaths (59%). Those who were alive at follow-up displayed high rates of unemployment (84%), illicit substance misuse (74%) and most were dependent on state-subsidised accommodation (78%).CLINICAL IMPLICATIONSMortality was higher in our group compared with other long-term follow-up samples. These findings suggest that such participants and their offspring require intensive long-term support and treatment.

Download Full-text