Fentanyl and heroin use decrease significantly during the first year in methadone-treated patients for opioid use disorder.Johns Hopkins


A new study led by researchers at the Johns Hopkins Bloomberg School of Public Health found that the proportion of patients treated for opioid use disorder with methadone significantly reduced fentanyl use during one year of treatment. The percentage of people testing positive decreased on average from 21.8% at week 1 to 17.1% at week 52.

Average heroin positivity also fell from 8.4% to 4.3%. Both heroin and fentanyl showed the greatest reductions in his first 10 weeks of treatment. Mean positivity rates for methamphetamine and cocaine did not change significantly during the 52-week treatment period.

For their study, researchers analyzed urine specimens of patients treated at methadone clinics from more than 16,000 individuals in 10 states between January 1, 2017, and December 31, 2021. , detected fentanyl, heroin, cocaine, methamphetamine and other illegal substances. The researchers analyzed urine specimens covering the individual’s first 52 weeks of observation on treatment.

The study was published online in the journal May 9 Addiction.

Methadone is approved by the Food and Drug Administration to treat symptoms of opioid use disorders such as cravings and withdrawal symptoms.

“Patients are increasingly testing positive for fentanyl and other illicit drugs at the start of treatment, and our study shows that patients significantly reduce illicit opioid use during one year of methadone treatment. ,” said Dr. Brendan Saloner. Lead author of the study in the Department of Health Policy and Management. β€œAt the same time, methamphetamine and cocaine use rates are rising and generally not declining in his one year of methadone treatment. It helps us to be able to provide support.”

Researchers analyzed anonymized urine samples from Millennium Health’s proprietary database. Millennium Health is a drug testing laboratory serving all 50 states. Study samples were drawn from patients diagnosed with opioid use disorders who were receiving methadone treatment and who had at least 3 valid urine specimens in the database. Researchers used data from Alaska, Arizona, Florida, Illinois, Kentucky, Minnesota, New Mexico, Ohio, Virginia, and Washington. The analysis included her 194,333 specimen samples from 16,386 individual patients.

Researchers found initial urine specimens collected over the five-year study period showed an increase in fentanyl-positive rates in the broader population, rising from 13.1% in 2017 to 53% in 2021 Did. His methamphetamine positive rate also increased from 10.6% to 27.2%. The percentage increased from 13.8 percent to 19.5 percent, similar to cocaine.

Additional analysis found that fentanyl positivity was significantly higher in men compared with women. It was also significantly higher in the 18-24 year old group than in all other age groups. Fentanyl positivity rates were highest in Ohio, Illinois, Arizona, Kentucky, and Minnesota. Alaska had the highest positivity rates for heroin and methamphetamine.

“Methadone treatment can be very successful in reducing fentanyl and heroin use in individuals, but this study shows that it does not address the complexities of multi-substance use,” Saloner said. “The findings are a wake-up call that we need more tools to support other types of substance use.”

“Polydrug Use in Patients on Methadone Medication: Evidence from Urine Drug Testing to Inform Patient Safety,” Brendan Saloner, Penn Whitley, Eric Dawson, Stephen Passic, Adam Gordon, and written by Bradley Stein.

This research was supported by funding from the National Institute on Drug Abuse #R01DA045800.

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Media Contact: Christine Henry khenry39@jhu.edu and Barbara Benham bbenham1@jhu.edu



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