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Heroin Addiction and Related Clinical Problems: 2017, 19, N6 (pages: 57 - 64)

How to Improve a Poorly Running Agonist Opioid Treatment (Aot). Part 4: dosage Splitting

Ulmer A., Klein M., and Meinhold C.

Summary: Introduction: Since the beginning of methadone maintenance therapies it has been standard to provide methadone once a day (QD). Providers want to be re-ally sure that methadone is being swallowed. Therefore not many studies with the usual standard have examined if it wouldn't be better to split the daily dose. This is only consensus for pregnant women. But the overall results of methadone treatments are still too often disappointing. If we look closely, we recog-nize that many patients come to their methadone intake in a bad and hardly suf-ferable condition. It's impressive, how they describe the difference between before and afterwards. That can't be physiological. It's certainly complicit in the limitation of good results. Methods: We have interviewed 97 patients about the-se differences. Results: The answers indicate significant differences between QD- and intake twice or more times daily. Withdrawal symptoms of QD intaking patients were reported in nearly double intensity. Conclusions: There is a clear plea for split dosing, at least of methadone and levomethadone, but better of all AOT medication.