Methadone Maintenance Therapy

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Methadone is a synthetic opioid used as a pain medication and as maintenance therapy for people with opioid dependence. Methadone can be dispensed by nurses and is the widely chosen treatment for addicts. It has a side effect of insomnia, is expensive to obtain, has been shown to reduce morality, illicit opioid use, criminal behavior, and HIV risk factors. Methadone can also cause unintentional over dose when used with continued use of other opioids.

I believe methadone is relevant to my practice as a Practical nurse because of its wide variety of uses. It is used to treat chronic pain, alcoholics, and drug addicts. I believe future research into methadone will show more of its side effects and benefits. This will impact my scope as a nurse
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(Soleimani, Modabbernia, Habibi, Habibi and Elahi 2015). With increased insomnia associated with higher doses of methadone. Cognitive behavior therapy was used on patients in the trial for 'The Effectiveness of Cognitive Behaviour Therapy in Insomnia due to Methadone Maintenance Therapy: A Randomized clincal trial' and significantly decreased insomnia. Cognitive behavior therapy in studies done on alcoholism significantly decreased relapse. (Soleimani, et al. 2015).

The cost of methadone maintenance therapy in Canada per day is estimated to be $15.65 and $5651 per year. These costs increase if patients have increased doctors visits or higher methadone doses. (Zaric, Brennan, Varenbut and Daiter.2012). In Ontario patients who qualify, drug costs and pharmacy fees are paid publicly by the Ontario Drug Benefit program. It is paid privately for the patients for who do not qualify. Many studies on cost-effectiveness do not consider other patient costs beyond treatment when planing the budget for drug programs.(Jackson, Mandell, Johnson, Chatterjee & Vanness
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During early stages of the trial 'Use of Opioids during Methadone Therapy: A Population based study', 1 in 5 patients filled at least one prescription for a non-methadone opioid for more then 7 days. Almost half of these prescriptions were not prescribed or filled by the patients doctor or pharmacist involved in their methadone treatment. When mixed with other drugs methadone can cause potential for fatal over dose.(Kurdyak et al. 2012). There is evidence that patients continue to use illicit substances by urinalysis samples showing heroin and other substances.(Duffy & Mackridge 2014). This is where I believe that nurses will come into play in the future with helping to counsel patients on the use of methadone, by building trusting relationships with the patients first they will be more willing to open up and trust the