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Dear Doctor Letter by J. Thomas Payte, M.D.
Education Series Number 9 January 1999 Letter Supplement O N Y O U R L E T T E R H E A D Dear Doctor: The bearer of this letter is a patient in a methadone maintenance treatment program. Methadone patients frequently need treatment for other medical, surgical, and dental conditions. At times the health professional…
Denying Methadone Patients Medical Care
The bias and misunderstandings about methadone as a medication often result in methadone patients being refused medical care (Umbricht-Schneiter, 1994; Zweben and Sorensen, 1988). Another common scenario is that their medication is used to coerce or manipulate methadone patients into medical treatment (Blansfield, 1992). In other areas of medicine such actions would be considered unethical…
Diluting Methadone To Liquid Form – Practice, Negative Impact, Diversion
The dilution of methadone with water was initiated as a result of the first federal methadone regulations because it was believed that this policy would reduce the diversion of methadone. While initially this policy may have had an impact within a short time most prospective buyers learning that methadone was now diluted with water and…
The Pharmacology of Opioids
Basic Pharmacology: How Methadone Works Part 2 Basic Opioid Pharmacology All natural and synthetic opioids exhibit a three dimensional T-shaped configuration (Barchas, Berger, Ciaranello and Elliott, 1977). This T-shaped molecule has two broad hydrophobic surfaces which are at right angles and a methylated nitrogen which is usually charged at physiological pH. The charged nitrogen is…
Blind Dosing
Methadone maintenance treatment has been the most effective treatment for addiction to heroin resulting the cessation of heroin use and criminal behavior. Prior to the development of methadone maintenance treatment over 28 years ago narcotic addiction was considered incurable and a behavioral disorder under the control of law enforcement. Drs. Dole and Nyswander brought the…