scholarly journals Comparison of Pain Tolerance between Opioid Dependent Patients on Methadone Maintenance Therapy (MMT) and Opioid Naive Individuals

2016 ◽  
Vol 19 (1) ◽  
pp. 127 ◽  
Author(s):  
Zalina Zahari ◽  
Chee Siong Lee ◽  
Muslih Abdulkarim Ibrahim ◽  
Nurfadhlina Musa ◽  
Mohd Azhar Mohd Yasin ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Methadone Maintenance ◽  
Cold Pressor Test ◽  
Cold Pressor ◽  
Methadone Maintenance Therapy ◽  
Pain Tolerance ◽  
Methadone Dose ◽  
Methadone Dosage ◽  
The Past ◽  
History Of

Purpose: This study compared pain sensitivity among opioid dependent patients on methadone maintenance therapy (MMT) and opioid naive subjects. Methods: The three hundred participants comprised 152 opioid naive subjects and 148 opioid dependent patients. Opioid naive subjects had not taken any opioids including morphine and methadone to their best knowledge and were presumed so after two consecutive negative urine screenings for drugs. All opioid dependent patients were stabilized in treatment, defined as having been enrolled in the program for more than one month with no change of methadone dosage over the past one month. Excluded from the study were individuals with chronic or ongoing acute pain and individuals with a history of analgesics ingestion within 3 d before the cold pressor test (CPT). Pain tolerance to CPT was evaluated at 0 h, and at 2, 4, 8, 12, and 24 h post-methadone dose. Results: Patients exhibited a significantly shorter mean pain tolerance time of 34.17 s (95% CI 24.86, 43.49) versus 61.36 (52.23, 70.48) [p < 0.001] compared with opioid naive subjects. Time-dependent mean pain tolerance was also significantly different when naive subjects were compared to patients (p = 0.016). Conclusions: This study revealed hyperalgesia amongst patients on MMT, as manifested by their quicker hand withdrawal. The complaints of pain in this population should not be underestimated and the pain should be evaluated seriously and managed aggressively. This article is open to POST-PUBLICATION REVIEW. Registered readers (see “For Readers”) may comment by clicking on ABSTRACT on the issue’s contents page.

scholarly journals Stercoral Perforation Requiring Subtotal Colectomy in a Patient on Methadone Maintenance Therapy

2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
A. Sakharpe ◽  
Y. K. Lee ◽  
G. Park ◽  
V. Dy
Keyword(s):  
Maintenance Therapy ◽  
Subtotal Colectomy ◽  
Surgical Intervention ◽  
Methadone Maintenance ◽  
Rare Condition ◽  
Methadone Maintenance Therapy ◽  
Heroin Use ◽  
Stercoral Perforation ◽  
History Of

Stercoral perforation of the colon is a rare but serious complication of chronic constipation. We present a case of stercoral perforation requiring subtotal colectomy in a 41-year-old female who had been on methadone maintenance for a history of long-term intravenous heroin use. Our case highlights the importance of prompt and thorough surgical intervention in the successful treatment of this rare condition.

scholarly journals Objective pain sensitivity affects sleep quality in opioid dependent males on methadone maintenance therapy

2014 ◽  
Author(s):  
Zalina Zahari ◽  
Chee Siong Lee ◽  
Soo Choon Tan ◽  
Nasir Mohamad ◽  
Yeong Yeh Lee ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Sleep Quality ◽  
Pain Sensitivity ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Pain Tolerance ◽  
Opiate Withdrawal ◽  
Tolerance Time ◽  
Male Patients ◽  
The Mean

Aim Pain associated poor sleep quality has been reported among opioid dependent patients on methadone maintenance therapy (MMT) but objective pain data are lacking. This study aimed to investigate the rate of objective pain sensitivity and the relationship between pain sensitivity and sleep quality in this susceptible male population. Methods A total of 168 male patients from MMT clinic in Kelantan, Malaysia were included into the study. Objective pain tolerance to cold pressor test (CPT) was evaluated at 0 hour and at 24 hours after the first CPT. Malay version of the Pittsburgh Sleep Quality Index – PSQI and the subjective opiate withdrawal scale (SOWS) questionnaires were administered to evaluate the quality of sleep and withdrawal symptoms, respectively. Results The mean age of the study participants was 37.22 (SD 6.20) years old. The mean daily methadone dose was 76.64 (SD 37.63) mg/day. The mean averaged SOWS score was 5.43 (SD 6.91). The averaged pain tolerance time ranged from 7 to 300 s with a mean time of 32.16 (SE 2.72) s, slightly below the cut-off score of 37.53 s. More specifically, 78.6% (n = 132) of patients were identified as ‘pain-sensitive’ (averaged pain tolerance time ≤ 37.53 s), and 36 (21.4%) were ‘pain-tolerant’ patients (averaged pain tolerance time > 37.53 s). The mean global PSQI score was 5.47 (SD 2.74). The pain-sensitive patients reported poorer sleep quality with mean (SD) of 5.78 (2.80) compared with pain-tolerant patients with mean (SD) of 4.31 (2.18) (p = 0.005). With analysis of covariance, pain-sensitive patients were found to have higher global PSQI scores (adjusted mean 5.76, 95% CI 5.29; 6.22) than pain-tolerant patients (adjusted mean 4.42, 95% CI 3.52; 5.32) (p = 0.010). Conclusions Many opioid dependent male patients on MMT are pain-sensitive. A poorer sleep quality is associated with objective pain sensitivity. Pain and sleep complaints in this susceptible population should not be overlooked.

scholarly journals Objective pain sensitivity affects sleep quality in opioid dependent males on methadone maintenance therapy

2014 ◽  
Author(s):  
Zalina Zahari ◽  
Chee Siong Lee ◽  
Soo Choon Tan ◽  
Nasir Mohamad ◽  
Yeong Yeh Lee ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Sleep Quality ◽  
Pain Sensitivity ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Pain Tolerance ◽  
Opiate Withdrawal ◽  
Tolerance Time ◽  
Male Patients ◽  
The Mean

Aim Pain associated poor sleep quality has been reported among opioid dependent patients on methadone maintenance therapy (MMT) but objective pain data are lacking. This study aimed to investigate the rate of objective pain sensitivity and the relationship between pain sensitivity and sleep quality in this susceptible male population. Methods A total of 168 male patients from MMT clinic in Kelantan, Malaysia were included into the study. Objective pain tolerance to cold pressor test (CPT) was evaluated at 0 hour and at 24 hours after the first CPT. Malay version of the Pittsburgh Sleep Quality Index – PSQI and the subjective opiate withdrawal scale (SOWS) questionnaires were administered to evaluate the quality of sleep and withdrawal symptoms, respectively. Results The mean age of the study participants was 37.22 (SD 6.20) years old. The mean daily methadone dose was 76.64 (SD 37.63) mg/day. The mean averaged SOWS score was 5.43 (SD 6.91). The averaged pain tolerance time ranged from 7 to 300 s with a mean time of 32.16 (SE 2.72) s, slightly below the cut-off score of 37.53 s. More specifically, 78.6% (n = 132) of patients were identified as ‘pain-sensitive’ (averaged pain tolerance time ≤ 37.53 s), and 36 (21.4%) were ‘pain-tolerant’ patients (averaged pain tolerance time > 37.53 s). The mean global PSQI score was 5.47 (SD 2.74). The pain-sensitive patients reported poorer sleep quality with mean (SD) of 5.78 (2.80) compared with pain-tolerant patients with mean (SD) of 4.31 (2.18) (p = 0.005). With analysis of covariance, pain-sensitive patients were found to have higher global PSQI scores (adjusted mean 5.76, 95% CI 5.29; 6.22) than pain-tolerant patients (adjusted mean 4.42, 95% CI 3.52; 5.32) (p = 0.010). Conclusions Many opioid dependent male patients on MMT are pain-sensitive. A poorer sleep quality is associated with objective pain sensitivity. Pain and sleep complaints in this susceptible population should not be overlooked.

Exploring the mental status of people with opium and heroin addiction

2011 ◽  
Vol 26 (S2) ◽  
pp. 104-104 ◽  
Author(s):  
K.K. Shirazi ◽  
E. Heydarnia ◽  
S. Kamalianfard ◽  
M. Heydarnia ◽  
M. Fararooie ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Maintenance Therapy ◽  
Mental Status ◽  
Psychological Health ◽  
Methadone Maintenance ◽  
Methadone Maintenance Therapy ◽  
Heroin Addiction ◽  
Effective Interventions ◽  
History Of ◽  
History Of Depression

IntroductionIndividuals who engage in drugs abusing are more susceptible to a variety of physical, social and psychological health problems.ObjectiveThis study describes mental disorders of patients with opium and heroin addiction before taking MMT.MethodParticipants included 172 addicts (162 men and 10 women), referring to Fanoos addiction relief center, whose age ranged from 16–66 with mean age of 32.8. All participants were asked to complete a questionnaire about their bad feelings experienced during past month before taking methadone maintenance therapy.ResultsThe average age of the first drug abusing was 20.5 with range of 10–60. The most frequent bad feelings that were reported by participants were sensation of anxiety, hopelessness and aloneness. 68.6% of patients had a history of depression, 56.4% were aggressive and 26.3% of them had ideas of suicide.ConclusionsExploring of mental status of addict people before taking MMT can be used for evaluation of treatment effects and designing more effective interventions.

Relationship between CYP2B6*6 and cold pressor pain sensitivity in opioid dependent patients on methadone maintenance therapy (MMT)

2016 ◽  
Vol 165 ◽  
pp. 143-150 ◽  
Author(s):  
Zalina Zahari ◽  
Chee Siong Lee ◽  
Muslih Abdulkarim Ibrahim ◽  
Nurfadhlina Musa ◽  
Mohd Azhar Mohd Yasin ◽  
...  
Keyword(s):  
Maintenance Therapy ◽  
Pain Sensitivity ◽  
Methadone Maintenance ◽  
Cold Pressor ◽  
Methadone Maintenance Therapy ◽  
Cold Pressor Pain
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