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Related Experiment Videos

Single-day methadone dose alteration: detectability and symptoms.

M L Stitzer, G E Bigelow, I A Liebson

    Clinical Pharmacology and Therapeutics
    |August 1, 1984
    PubMed
    Summary

    Individuals on methadone maintenance can detect significant changes in their daily methadone dose, with withdrawal symptoms appearing after large dose decreases, regardless of whether they are informed about the changes.

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    Area of Science:

    • Pharmacology
    • Clinical Psychology
    • Addiction Medicine

    Background:

    • Methadone maintenance therapy (MMT) is a cornerstone treatment for opioid use disorder.
    • Understanding patient's ability to detect dose alterations is crucial for treatment adherence and safety.
    • Acute dose changes can impact treatment efficacy and patient well-being.

    Purpose of the Study:

    • To investigate the detectability of acute methadone dose alterations in patients undergoing MMT.
    • To examine the symptomatic effects associated with both increases and decreases in methadone dosage.
    • To assess the influence of information and taste cues on dose detection and symptomatic responses.

    Main Methods:

    • Three experiments involving subjects on MMT with altered daily methadone doses (0%-200% of stable dose).

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  • Varying information conditions: explicit information, taste cues only, and no information.
  • Assessment of dose detectability and symptomatic effects using checklists.

    • Main Results:

    • Large dose alterations (75%-100%) were reliably detected, with significant individual differences in sensitivity.
    • Taste cues aided detection but led to underestimation of dose magnitude.
    • Decreased doses were detected without taste cues, unlike increased doses.
    • Withdrawal symptoms increased after large dose decreases; dose increases had minimal symptomatic effects.

    Conclusions:

    • Patients on MMT can detect substantial acute methadone dose changes.
    • Symptomatic effects are more pronounced with dose decreases, particularly large ones.
    • Information and taste cues influence detection accuracy but not the occurrence of symptoms.