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Heroin Addiction and Related Clinical Problems: 2001, 03, 1 (pages: 13 - 22)

Haematic concentrations versus oral doses of methadone. Comparative assessment of two reference systems during substitute therapy in opiate addiction

Scarlata S., Chiarotti M., Fucci N., De Giovanni N.

Summary: Therapeutic failures in MMP patients may be due to an inadequate oppioidergic replacement effect of the drug on specific receptors for endogenous opiates. Even with oral doses considered adequate in the current literature, haematic levels may be low, due to genetic or induced over-metabolization of the drug; in addition, even when haematic levels are high, the results may be poor, due to acquired receptor tolerance. 61 heroin addicts on MMP doses agreed on between therapist and patient have been evaluated with Europasi at the beginning and at the end of observational and therapeutic periods ranging between 12 and 57 months. Addicts who showed a positive development revealed haematic levels (non-oral ones) higher than non-responder patients, and some of the former reached haematic levels higher than those reported in current literature. Estimates of the haematic concentration of methadone may be useful, even if availed of “una tantum” during the treatment period.