SRINAGARIND MEDICAL JOURNALVolume 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 PDFMethadone 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.
Methadone maintenance treatment; opioids; cravings for opioids; withdrawal symptoms