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Greenwald, M. K. (2002). Heroin craving and drug use in opioid-maintained volunteers: Effects of methadone dose variations. Experimental and Clinical Psychopharmacology, 10(1), 39-46. Retrieved from http://search.proquest.com/docview/614364383?accountid=34899 Comment by Yvonne Bustamante: Be sure to double space all of your work and papers, and all lines after the first line of each entry in your reference list should be indented one-half inch from the left margin. This is called hanging indentation. Otherwise very nice formatting.

The research questions being investigated in this article was to determine whether or not methadone dose variations would increase or decrease the craving of heroin (2002). The method involved volunteers that were found in the Detroit area through advertisement and through word of mouth, there were eighteen volunteers in total that completed the study out of 35, seventeen were disqualified due to continued heroin or other drug use or for not showing up when needed and each were given money for their participation (2002). There were 10 men and 8 women with 11 being African-American and 7 Caucasian. The study was conducted in two (2) phases, the first phase included each volunteer going into the clinic to have methadone given to them with the dosage increasing daily to where the withdrawal symptoms of the opiate use would decrease all together (2002). Each day they would come in, they were to let the physician know of the withdrawal symptoms and signs that they were experiencing and the dose of methadone would increase 5mg-10mg. this happened over a period of 36 days (2002). During phase 2, the volunteers were being weaned off of the methadone slowly to see if the craving of the opiates would come back and to see if there were signs of possible relapse, this occurred over a 36 day period. During each session, urine was taken and testing was done to ensure that there were no other opiates in their system. It was found that in Phase 2, the decrease in methadone did in fact have impact on the volunteers and each experienced withdrawal symptoms and signs of cravings for heroin and that two of the volunteers dropped out (2002). The results revealed that the detoxification process for each individual is different, therefore they were unable to state whether or not methadone actually does take the craving of heroin away completely, they did find that while the volunteers were on the methadone, the craving for heroin had in fact gone away once the dosage for each was maintained at the level that worked best for each (2002). One thing that should have been taken into consideration would have been to have the volunteers stay at the clinic the entire time the study was conducted, if this would have been the case, then the experimenter could have seen how long the methadone lasted for and see the signs of withdrawal and distress for themselves. If this would have happened then they would have been able to incorporate this into their study rather than letting the volunteers go home and then coming in the following day and then asking them a series of questions.

Cohen, L. J., Gertmenian-King, E., Kunik, L., Weaver, C., London, E. D., & Galynker, I. (2005). Personality measures in former heroin users receiving methadone or in protracted abstinence from opiates. Acta Psychiatrica Scandinavica, 112(2), 149-158. doi:http://dx.doi.org/10.1111/j.1600-0447.2005.00546.x

The objective in this article is the effectiveness of methadone maintenance therapy among those addicted to opiates, it compares personality traits between previous heroin addicts and those that are receiving methadone maintenance therapy to see if there is a difference between the selections of treatment (2005). The method used is 26 former heroin addicts that are receiving treatment through methadone maintenance therapy, 33 former heroin addicts that are withdrawn from the methadone maintenance therapy, and 43 individuals that are healthy with each having been compared on the Million Clinical Multiaxial Inventory-II along with the Temperament and Character Inventory (2005). The results showed that the 26 heroin addicts receiving methadone treatment therapy had a higher novelty seeking and lower self-directedness scores on the Temperament and Character Inventory and that both the 26 former heroin addicts receiving methadone treatment along with the 33 former heroin addicts withdrawn from methadone treatment scored higher in many scales on the Million Clinical Multiaxial Inventory-II than the 43 healthy individuals (2005). The 33 former heroin addicts scored higher on two cluster A Scales and the delusion disorder scale than both the 43 healthy individuals and the 26 heroin addicts that are currently receiving methadone treatment. In conclusion, it appeared that those who were previous opiate addicts may require additional treatment options than previously recognized and that therapeutic treatment may also be effective alongside of the Methadone Treatment Therapy (2005).

Rass, O., Kleykamp, B. A., Vandrey, R. G., Bigelow, G. E., Leoutsakos, J., Stitzer, M. L., . . . Mintzer, M. Z. (2014). Cognitive performance in methadone maintenance patients: Effects of time relative to dosing and maintenance dose level.Experimental and Clinical Psychopharmacology, 22(3), 248-256. doi:http://dx.doi.org/10.1037/a0035712

The objective in this article is to investigate the cognitive and psychomotor performance in in 51 methadone maintenance patients from the last methadone dose along with the maintenance dose level, these doses range from 40mg-200mg (2014). The participants were 51 methadone maintenance patients with 59% being women were recruited from an outpatient methadone clinic in Baltimore, these participants have been in the program for at least 6 months and the dosage varied for each. All of the participants were informed of what the study entailed and each signed a consent and were paid for their participation. The study was conducted by the participants completing two performance testing sessions within a week of each other. The participants would attend their regular clinic for dosing and then on session days, they would report to the research unit located at John Hopkins Behavioral Pharmacology. The participants were administered an oral solution 120 minutes before, and immediately after the performance testing battery for each of the two sessions. The testing that was performed were sensory processing, psychomotor function, attention, working memory, and episodic memory and metamemory (2014). Analysis was then conducted on each dependent measure in the cognitive battery, each session was relative to their dosing of methadone both during both the peak session of the methadone and their maintenance dose level. Results showed that both the cognitive and the psychomotor performances were worse at the peak time (120 minutes after taking the methadone) versus the maintenance level (about 26 hours after the methadone dose), however there was not enough to be clinically significant (2014).

Sarkar, S., & Mattoo, S. K. (2012). Newer approaches to opioid detoxification. Industrial Psychiatry Journal, 21(2), 163–167. doi:10.4103/0972-6748.119652

The objective in this article is to find other methods of detoxification for those that suffer from addiction to opiates. The strategy was that was conducted in October of 2011 was that 659 peer reviewed articles were identified using PubMed and PsychInfo databases with keywords used such as opioid and detoxification (2012). The researchers then gathered the results and method used from each of these articles and then further studied those (2012). The results showed that many of the non-opioids that have been used for detoxification have been effective in taking the cravings and withdrawal symptoms away, however if tapered off to quickly, the relapse rate is high. The medications that are be used for detoxification have proven to be effective, but the potential to misuse this medication is still an ongoing concern. Currently there is still no known medication that has been found that does not have potential for abuse that is cost effective, safe, and requires minimal monitoring (2012).

Amato L, Davoli M, Minozzi S, Ferroni E, Ali R, Ferri M. Methadone at tapered doses for the management of opioid withdrawal. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD003409. DOI: 10.1002/14651858.CD003409.pub4.

The objective in this article is to evaluate how effective the tapering is of methadone compared to the many other detoxification treatments and placebo for those addicted to opiates from withdrawal symptoms to the completion of the detoxification process (2013). This study also will show the relapse rate as well. There were 23 trials that took place among 2,467 people in which the researchers compared methadone to any other pharmacological treatment, and it was found that there was no difference (2013). There were 19 other studies that were completed on 1,381 participants, however the researchers found it to be impossible to pool the data for these individuals due to each experiencing different symptoms and each being on different dosages and different programs (2013). The conclusion showed that tapering methadone slowly was the most effective way for the opiate addict, however the relapse rate was still very high (2013).

So the question here is: Methadone, is this an effective alternative to opiate dependency and is it safe? When reading these articles, I expected to have my hypothesis confirmed along with more eye opening accounts to assist me in my personal and honest life situation. These articles have been very informative and helpful and will fit in with the research paper that is being done on effective treatment and chemical dependency. It shows that methadone can be very helpful and that given the right dose, it does take away the cravings and withdrawal symptoms and use of heroin, however, when it comes to tapering off of methadone, the process will take longer depending on the individual themselves. Successful recovery is not very high, but with the right supports in place, it appears as though it is possible, another factor to take in, is the mindset of the addict and their willingness and desire to quite using opiates. Through close monitoring of a physician, it is possible that this is an effective treatment option for those suffering addiction from opiates. Ongoing counseling to determine the root cause of the addiction along with possible future medication monitoring for the damages that the opiates may have caused is an another method that should fall hand and hand with the above statement.