SRINAGARIND MEDICAL JOURNAL

Volume 36, No. 01, Month JANUARY, Year 2021, Pages 119 - 126

Improvement of methadone maintenance treatment guideline for opioid dependency

Duangjai Duangrithi, Nutcha Cheewinaphirak, Rawiporn Jansiriyanan, Tananan Phetnil

Abstract Download PDF

Methadone maintenance treatment (MMT) is the supportive treatment with long-term use of methadone. It is the most effective treatment for opioid dependency. The treatment retention is the important factor for treatment success. It was found that the retention rate of MMT in Thailand was low. Therefore, MMT guideline should be reviewed and improved in order to increase treatment retention. Inclusion criteria need to be included the counseling and social support for patients less than 18 years since they are high risk of drop-out. In addition, the contraindication and allergy to methadone should be included in exclusion criteria for patient safety. The higher dose of methadone should be considered for patients with cravings for opioids and withdrawal symptoms. Treatment duration of MMT should not be less than 1 year. Furthermore, treatment monitoring for induction period should focus on effectiveness and adverse effect of methadone while the risk of relapse and psychosocial function need to be assessed in maintenance phase. Treatment guideline for breastfeeding women should be added. The strategies for improving adherence consisting of medical services improvement, education and behavioral counseling, family oriented activities, job training and recruitment should be emphasized.

Keywords

Methadone maintenance treatment; opioids; cravings for opioids; withdrawal symptoms

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