Symptom complaints of patients prescribed either oral methadone or injectable heroin

Dürsteler-MacFarland, Kenneth M.; Fischer, Dominique A.; Mueller, Sandra; Schmid, Otto; Moldovanyi, Andreas; Wiesbeck, Gerhard A.

doi:10.1016/j.jsat.2010.01.008

« Previous Next »Journal of Substance Abuse Treatment
Volume 38, Issue 4 , Pages 328-337, June 2010

Symptom complaints of patients prescribed either oral methadone or injectable heroin

Kenneth M. Dürsteler-MacFarland, M.A.
- Psychiatric Hospital of the University of Basel, Division of Substance Use Disorders, 4025 Basel, Switzerland
- Psychiatric University Hospital Zurich, Division of Substance Use Disorders, 8002 Zurich, Switzerland
- Corresponding author. Psychiatric Hospital of the University of Basel, Wilhelm Klein-Strasse 27, CH-4025 Basel, Switzerland. Tel.: +41 61 325 5125; fax: +41 61 325 5364.
- These authors contributed equally to this study.
Dominique A. Fischer, Med. Pract
- Psychiatric Hospital of the University of Basel, Division of Substance Use Disorders, 4025 Basel, Switzerland
- These authors contributed equally to this study.
Sandra Mueller, M.Sc.
- Psychiatric Hospital of the University of Basel, Division of Substance Use Disorders, 4025 Basel, Switzerland
Otto Schmid, M.A.
- Psychiatric Hospital of the University of Basel, Division of Substance Use Disorders, 4025 Basel, Switzerland
Andreas Moldovanyi, Dr. Med.
- Psychiatric University Hospital Zurich, Division of Substance Use Disorders, 8002 Zurich, Switzerland
- Polyclinics for Heroin Prescription Lifeline/Crossline, City Medical Services, 8001 Zurich, Switzerland
Gerhard A. Wiesbeck, Dr. Med.
- Psychiatric Hospital of the University of Basel, Division of Substance Use Disorders, 4025 Basel, Switzerland

Received 10 July 2009; received in revised form 11 January 2010; accepted 15 January 2010. published online 08 March 2010.

Abstract

Many methadone patients and untreated heroin users have an ambivalent attitude toward methadone maintenance. This may be a result of the widespread belief that methadone produces various side effects not found with heroin. This study compared the symptom complaints of patients on oral methadone maintenance (MMT) with those of patients prescribed injectable heroin (IHT). A convenience sample of 117 (63 MMT, 54 IHT) patients was recruited from two maintenance clinics. With the use of a self-completion questionnaire, patients were interviewed about a range of symptoms they had experienced and which, in their view, were due to maintenance substance immediately after the last 10 opioid administrations, during the previous week and previous year. The complaints of the two groups overlapped considerably with only few significant differences; these appeared related to the route of administration. IHT patients reported a larger number of complications experienced immediately after administration than MMT patients (p = .007). From the patients' view, methadone does not produce many more or side effects very different from heroin and thus seems at least as tolerable as heroin for maintenance treatment.

Keywords: Heroin, Methadone, Opioid dependence, Maintenance treatment, Symptom complaints, Side effects