methadone / Generic mfg. - LARVOL DELTA

Polydrug abuse: Choice between drugs as a function of concurrent nonindependent ratio sizes. (PubMed, J Exp Anal Behav) - "The present study provided rhesus monkeys concurrent access to two drugs: 8% alcohol and solutions of either cocaine or methadone...Consumption of the alternative liquid generally remained elevated over initial values when schedule size decreased. The data can be analyzed in several ways, including consumption as a function of price (behavioral economics) and log of relative response rates as a function of log of relative deliveries (matching), thereby providing an interface between behavioral economics and matching analyses."

Journal • Addiction (Opioid and Alcohol)

U.S. states opting out of expanded methadone take-home policies and associated mortality. (PubMed, J Subst Use Addict Treat) - "States who continued expanded take-home methadone dosing did not subsequently experience a detectable increase in methadone-related overdose deaths relative to states that opted out of the policy. This evidence suggests that policies expanding methadone take-homes are safe at a population level, which can inform deliberations within states that currently maintain strict restrictions."

Journal • Infectious Disease • Novel Coronavirus Disease

The Double Duct Dilemma: When Methadone Mimics Malignancy (ACG 2025) - "The hospitalization was complicated by persistent opioid-induced constipation, which responded to methylnaltrexone, and the patient was discharged with outpatient surgical referral for elective cholecystectomy. This case highlights a clinically relevant association between chronic methadone use and the double duct sign. While MMT use remains prevalent, specialists should remain vigilant for its potential to mimic more serious conditions. Recognizing this association may help avoid unnecessary invasive procedures and guide individualized diagnostic and therapeutic strategies.Figure: Double Duct on MRCPFigure: Double Duct EUS"

Cholestasis • Constipation • Gastroenterology • Gastrointestinal Disorder • Oncology • Substance Abuse

Buprenorphine maintenance treatment and its outcome among opioid dependent pregnant women: A case series from India. (PubMed, Indian J Psychiatry) - "Opioid agonist maintenance treatment with buprenorphine or methadone has been the recommended treatment for opioid dependence during pregnancy for various reasons. There is scarcity of literature in this regard. This is first report from India presenting cases of pregnancy with opioid dependence with buprenorphine maintenance treatment and its outcomes."

Journal • Addiction (Opioid and Alcohol)

Machine learning model for predicting hepatitis C seroconversion in methadone maintenance patients in China. (PubMed, BMJ Public Health) - "A publicly accessible web tool was generated for the model. The developed XGBoost model has the potential to accurately predict individuals on MMT programmes at high risk of HCV seroconversion."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Hepatitis C • Human Immunodeficiency Virus • Infectious Disease • Inflammation • Psychiatry • Substance Abuse

Cost-Effectiveness of Treatment for Opioid Use Disorder in Pregnancy and Its Impact on Birth Outcomes. (PubMed, JAMA Pediatr) - "Mean cost savings ranged from $25 316 per person ($2.03 billion; IQR UI, $1.83-$2.21 billion; naltrexone-oral) to $46 437 per person ($3.71 billion; IQR UI, $3.47-$3.96 billion; naltrexone-XR). Results of this analysis suggest that both methadone and buprenorphine remained viable options for managing OUD during pregnancy and post partum; however, buprenorphine offered the greatest benefits in the lifetime models that account for infant outcomes."

HEOR • Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry • Substance Abuse

Long-Term Neuropathic Pain Management Following Thoracolumbar Neurinoma Surgery: A Case Report withMultimodal and Neuromodulation Strategies (NeuPSIG 2025) - "Psychological screening questionnaires revealed positive scores for anxiety and depression at baseline, highlighting the need for an integrated biopsychosocial approach.Strategies included medication adjustments (carbamazepine, duloxetine, trazodone, methadone, and eventually tapentadol), cannabis-based therapy, epidural and transforaminal blocks, pulsedradiofrequency (PRF) of dorsal root ganglia (DRGs), sympathetic blocks via venous access (BSV), and spinal cord stimulation (SCS)...Within one week, the patient experienced a 70% reduction in pain, with a mean pain score of 2/10 and low interference in daily function: 30% for general activity and interpersonal relations, and no interference with work or enjoyment of life.This improvement was achieved while maintaining a stable regimen of duloxetine, trazodone, methadone, and pregabalin... This case demonstrates the value of individualized, stepwise multimodal management for complex neuropathic pain, especially when..."

Case report • Clinical • Surgery • CNS Disorders • Depression • Neuralgia • Pain • Psychiatry

Cannabis and Cancer Pain: A Case of Respiratory Depression with Concomitant Use of Opioids and Cannabinoids (PAINWeek 2025) - "The patient’s home pain regimen consisting of oral morphine, hydromorphone, fentanyl, pregabalin, and duloxetine were not providing her with adequate management, her average Morphine Equivalent Daily Dose (MEDD) prior to hospitalization was 350-500. She described the pain as 8/10 constant “labor-like” pain focally around her abdomen and pelvic region with no alleviating factors. Palliative discontinued oral morphine and transdermal fentanyl in favor of starting her on methadone with a hydromorphone patient-controlled analgesia (PCA) with a concurrent continuous hydromorphone rate."

Clinical • CNS Disorders • Depression • Mood Disorders • Pain • Psychiatry • ERBB3

Effect of Long-Term Opioid Therapy on Sexual Dysfunction in Pain Patients (PAINWeek 2025) - "Patients treated with buprenorphine have been shown to have increased levels of serum testosterone and lower frequency of sexual dysfunction as compared to methadone maintenance treatment... Three hundred and thirty-eight patients were screened; 45 patients were included in the buprenorphine group and 55 in the opioid group. Most common reason for study exclusion was no proceeding 90-day opioid-free interval. There were no significant differences in baseline characteristics, including age, body mass index, and concomitant antidepressant therapy, between study groups."

Clinical • CNS Disorders • Pain

Global occurrence and distribution of drugs of abuse in rivers: A comprehensive systematic review. (PubMed, Sci Total Environ) - "This systematic literature review examines the global occurrence and distribution of ten highly consumed drugs in rivers, including stimulants (cocaine, amphetamine, methamphetamine, 3,4-methylenedioxy-methamphetamine or MDMA, ketamine) and opioids (codeine, fentanyl, methadone, morphine, tramadol). The review also highlights a disconnect between drug doses used in most ecotoxicity studies and typical levels found in surface waters, and a lack of data on drug attenuation kinetics in rivers. Future research should prioritize assessing drug persistence and aquatic toxicity under environmentally realistic conditions to guide risk assessment efforts and support more effective strategies for mitigating drug pollution in freshwater ecosystems."

Journal • Review

A combined cholecystoduodenocolic and gastrocolic fistula with a common orifice in the colon: A case report. (PubMed, Int J Surg Case Rep) - "Simultaneous fistulization involving the gallbladder, stomach, duodenum, and colon is possible, though rare. This case underscores the importance of thorough individualized surgical approaches to optimize outcomes in similar cases."

Journal • CNS Disorders • Gastroenterology • Pain • Peptic Ulcer • Psychiatry

Population-based prescription opioid use rate in Newfoundland and Labrador: A retrospective cohort study. (PubMed, J Opioid Manag) - "In comparison to national averages in Canada, NL had lower prescription opioid use rates. This study acts as a first step to better understand opioid use and prescribing practices in NL."

Journal • Retrospective data • Pain • Pediatrics • Substance Abuse

Linkage to Outpatient Methadone Treatment From the Emergency Department and Hospital. (PubMed, Acad Emerg Med) - No abstract available

Journal

A Stepwise Approach to Transitioning from Methadone to Buprenorphine for Cancer-Related Pain in an Outpatient Setting: A Novel Opioid Rotation Without Clinically Evident Withdrawal Symptoms. (PubMed, J Pain Palliat Care Pharmacother) - "A gradual transition from methadone to buprenorphine represents a safe and effective outpatient strategy for managing cancer-related pain. Future research should focus on refining micro-induction protocols and exploring precision medicine in opioid transitions."

Journal • Oncology • Pain

Key-Informant Perspectives On Pharmacy-Based Methadone Treatment For Opioid Use Disorder In The US. (PubMed, Health Aff (Millwood)) - "Barriers included stigma, financial obstacles, and unclear regulations. Legislative and regulatory changes could expand access to methadone."

Journal • Addiction (Opioid and Alcohol) • Substance Abuse

Improving Access To Substance Use Disorder Care In Nursing Facilities. (PubMed, Health Aff (Millwood)) - "This article provides an overview of the regulatory landscape and reviews existing efforts to improve the uptake of care for SUD in US nursing facilities, including educational and technical assistance programs; policy toolkits; state-based financial incentives; and collaborations among nursing facilities, community-based addiction services, and hospital systems. We also discuss broader reforms, such as improving reimbursement for SUD treatment, reducing regulatory barriers for methadone treatment, standardizing facility policies related to SUD care, and aligning quality measures with financial incentives."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry • Substance Abuse

The Opioid Crisis: Scaling Up Treatment And Harm Reduction Programs To Reach More People Who Would Benefit. (PubMed, Health Aff (Millwood)) - "The opioid crisis spurred numerous inventive approaches such as buprenorphine administered by paramedics and vehicles equipped to dispense methadone...Similarly, harm reduction programs such as syringe services programs and naloxone distribution are vastly underused. Scaling interventions to reduce harm and treat people with OUD will require addressing both technical constraints, such as program complexity, and social barriers, such as opposing community views, to develop effective programs and ensure that they are used by those who need them most."

Journal • Substance Abuse

Comparative effectiveness of alternative initial doses of opioid agonist treatment for individuals with opioid use disorder: a protocol for a retrospective population-based study using target trial emulation in British Columbia, Canada. (PubMed, BMJ Open) - "As opioid tolerance levels have risen in the fentanyl era, linked population-level data capturing initial doses in the real world provide a valuable opportunity to refine existing guidance on optimal OAT dosing at treatment initiation. Our objective is to determine the comparative effectiveness of alternative initial doses of methadone, buprenorphine-naloxone and slow-release oral morphine at OAT initiation, as observed in clinical practice in British Columbia (BC), Canada...The protocol, cohort creation and analysis plan have been classified and approved as a quality improvement initiative by Providence Health Care Research Ethics Board and the Simon Fraser University Office of Research Ethics. Results will be disseminated to local advocacy groups and decision-makers, national and international clinical guideline developers, presented at international conferences and published in peer-reviewed journals electronically and in print."

Clinical • HEOR • Journal • Retrospective data • Addiction (Opioid and Alcohol) • Substance Abuse

Restrictive State Opioid Treatment Program Regulations Constrain Local Access To Methadone Maintenance Treatment. (PubMed, Health Aff (Millwood)) - "In this study of comprehensive data on methadone shipments to OTPs in 2019, we found that ZIP codes just across the border in states with low restrictiveness in OTP regulations had more than twice the OTP density and methadone shipments compared with nearby and otherwise similar ZIP codes in states with high restrictiveness. These findings suggest that restrictive state OTP regulations constrain geographic access to methadone maintenance treatment and that easing such restrictions is a viable strategy to expand access."

Journal • Substance Abuse

My Methadone Journey: The Gold Standard In Frustration. (PubMed, Health Aff (Millwood)) - "A person with opioid use disorder navigates ineffective treatment before receiving methadone, which works but is hampered by restrictions."

Gold standard • Journal • Substance Abuse

Private Equity Acquiring Large Shares Of The Opioid Treatment Market Without Changing Market-Level Methadone Supply. (PubMed, Health Aff (Millwood)) - "Findings suggest that PE acquisitions of OTPs may consolidate ownership of OTPs among financial investors without changing methadone supply. Given policy makers' widespread call for increased supply, additional scrutiny of the impact of PE investment on patient access to methadone might be warranted."

Journal • Addiction (Opioid and Alcohol)

Cardiac Assessment of Individuals with Opioid Use Disorder under Methadone Treatment. (PubMed, J Res Pharm Pract) - "These findings suggest dose- and time-dependent cardiotoxic effects of methadone. Clinicians should implement cardiac monitoring, dose minimization, and risk-reduction strategies for patients on long-term methadone therapy."

Journal • Addiction (Opioid and Alcohol) • Cardiovascular • Chronic Kidney Disease • CNS Disorders • Diabetes • Hepatology • Hypertension • Liver Failure • Metabolic Disorders • Psychiatry • Renal Disease • Substance Abuse

Effectiveness of Washington State's hub and spoke model to improve opioid use disorder outcomes. (PubMed, Health Aff Sch) - "Our null findings likely reflect the complexity of the OUD crisis, the many needs of people with OUD that require flexible approaches at the individual and systems levels, and the WA-HS focus on MOUD initiation. Findings highlight the need to ensure HS models incorporate strategies to address MOUD continuity to drive long-term recovery for people with OUD."

Journal • Addiction (Opioid and Alcohol) • CNS Disorders • Psychiatry • Substance Abuse

Short-term stability evaluation of synthetic opioids, cathinones and ketamine in dried urine spots. Method validation and application to real cases. (PubMed, Forensic Sci Int) - "This study validates an LC-MS/MS method for the simultaneous quantification of twelve psychoactive drugs in DUS: methadone, EDDP, oxycodone, tapentadol, tramadol, ketamine, norketamine, fentanyl, carfentanyl, furanyl fentanyl, 3,4-MD-α-PHP, and MDPV. Nevertheless, molecule-specific stability profiles necessitate tailored validation strategies. Future studies should expand the analyte range and assess long-term stability under variable environmental conditions."

Journal • Addiction (Opioid and Alcohol) • Anesthesia

Comparative effectiveness of urine drug testing schedules alongside opioid agonist treatment: Emulation of a population-based target trial in British Columbia, Canada. (PubMed, Addiction) - "Compared with no urine drug testing, weekly urine drug testing may be associated with improved opioid agonist treatment retention; however, the high costs attributable to frequent testing may not be cost-effective and requires further evaluation. There was no improvement associated with less frequent testing compared with no monitoring."

HEOR • Journal • Oncology • Palliative care • Substance Abuse