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Methadone complications amongst opioid-dependent patients in Malaysia: A case series
Philip George1, Balasingam Vicknasingam2, Sivakumar Thurairajasingam3
1School of Medicine, International Medical University, Kuala Lumpur, Malaysia.
Introduction And Aims:
Opioid dependence remains the main type of illicit substance used in Malaysia, which has an estimated 187 771 opiate users. There are currently 333 active methadone maintenance treatment centres nationwide. Although methadone has proven to be an effective maintenance therapy, it has clinical concerns which can have an impact on its effectiveness and safety.
Design, Methods And Results:
A case series of seven patients from Malaysian private and public hospital settings who had an adverse reaction with methadone is discussed.
Discussion And Conclusion:
Despite methadone being an effective therapy for opioid dependence, there is a need for other alternative effective therapies, such as naltrexone, buprenorphine and the co-formulation of buprenorphine-naloxone, to be made available to physicians in both public and private sectors. There is need for individual treatment consideration to avoid adverse effects, drug-drug interactions, overdosing and in the presence of co-morbidities. An emphasis on safe storage of takeaway methadone is also needed. [George P, Vicknasingam B, Thurairajasingam S, Ramasamy P, Mohd Yusof H, Yasin MABM, Shah ZUBS. Methadone complications amongst opioid-dependent patients in Malaysia: A case series. Drug Alcohol Rev 2018;37:147-151].
Insights
Methadone maintenance therapy is effective for opioid dependence but can cause adverse reactions. Alternative treatments and individualized care are crucial for patient safety and treatment success in Malaysia.
Area of Science:
- Addiction Medicine
- Pharmacology
- Public Health
Background:
- Opioid dependence is a significant public health issue in Malaysia, with a large user population.
- Methadone maintenance therapy is a primary treatment, but clinical concerns exist regarding its safety and effectiveness.
Purpose of the Study:
- To present a case series of patients experiencing adverse reactions to methadone.
- To highlight the need for alternative opioid dependence treatments and individualized patient care.
Main Methods:
- A case series design was employed.
- Data were collected from seven patients in Malaysian public and private hospitals experiencing methadone adverse reactions.
Main Results:
- The case series details adverse reactions observed in patients undergoing methadone treatment.
- Specific adverse reactions and potential contributing factors were identified.
Conclusions:
- While methadone is effective, alternative therapies like naltrexone and buprenorphine are needed.
- Individualized treatment, consideration of comorbidities, and safe methadone storage are essential to mitigate risks.
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