PMID- 21489005
OWN - NLM
STAT- MEDLINE
DCOM- 20111027
LR  - 20131121
IS  - 1360-0443 (Electronic)
IS  - 0965-2140 (Linking)
VI  - 106
IP  - 9
DP  - 2011 Sep
TI  - Physical and mental health in severe opioid-dependent patients within a 
      randomized controlled maintenance treatment trial.
PG  - 1647-55
LID - 10.1111/j.1360-0443.2011.03463.x [doi]
AB  - AIMS: To evaluate physical and mental health and compare treatment outcomes in 
      opiate-dependent patients substituted either with heroin or methadone. DESIGN: 
      Twelve-month open-label randomized controlled trial. SETTING: Out-patient 
      substitution clinics in seven German cities. PARTICIPANTS: A total of 1015 
      opiate-dependent individuals. MEASUREMENTS: Opiate Treatment Index-Health Scale 
      Score (OTI), Body Mass Index (BMI), serology for infectious diseases such as 
      hepatitis B, C and human immunodeficiency virus as well as tuberculosis, 
      Karnofsky Performance Scale (KPS), electrocardiogram (ECG), echocardiogram, 
      Symptom Checklist 90-R (SCL-90-R), Global Assessment of Functioning (GAF), 
      Modular System for Quality of Life and study medication-related serious adverse 
      events (SAE). FINDINGS: Improvements were found in both heroin and methadone 
      substituted patients regarding OTI, BMI, KPS, SCL-90-R, and GAF, but they were 
      more pronounced for the heroin group (analysis of variance, all P = 0.000). The 
      frequency of pathological echocardiograms decreased in the heroin group and 
      increased in the methadone group (chi(2) test, <0.05). Markers for infectious 
      diseases and frequencies of pathological ECGs did not differ between baseline and 
      12 months, or between treatment groups. Study medication-related serious adverse 
      events, all of which were treated successfully, occurred 2.5 times more often in 
      the heroin group. The majority of heroin-related SAEs (41 of 58) occurred within 
      a few minutes of the injections. CONCLUSIONS: The integration of severe injection 
      drug users either in methadone or heroin-assisted maintenance treatment has 
      positive effects on most physical and mental change-sensitive variables, with 
      heroin showing superior results. Due to medication-related adverse events, 
      patients should be observed for 15 minutes after a heroin injection.
CI  - (c) 2011 The Authors, Addiction (c) 2011 Society for the Study of Addiction.
FAU - Reimer, Jens
AU  - Reimer J
AD  - Centre for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, 
      Germany. reimer@uke.de
FAU - Verthein, Uwe
AU  - Verthein U
FAU - Karow, Anne
AU  - Karow A
FAU - Schafer, Ingo
AU  - Schafer I
FAU - Naber, Dieter
AU  - Naber D
FAU - Haasen, Christian
AU  - Haasen C
LA  - eng
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20110722
PL  - England
TA  - Addiction
JT  - Addiction (Abingdon, England)
JID - 9304118
RN  - 0 (Analgesics, Opioid)
RN  - 70D95007SX (Heroin)
RN  - UC6VBE7V1Z (Methadone)
SB  - IM
CIN - Addiction. 2011 Sep;106(9):1656-7. PMID: 21815927
MH  - Adult
MH  - Analgesics, Opioid/adverse effects/*therapeutic use
MH  - Analysis of Variance
MH  - Body Mass Index
MH  - Echocardiography
MH  - Electrocardiography
MH  - Female
MH  - Germany
MH  - Health Status
MH  - Health Status Indicators
MH  - Heroin/adverse effects/therapeutic use
MH  - Humans
MH  - Male
MH  - Mental Health/*statistics & numerical data
MH  - Methadone/adverse effects/therapeutic use
MH  - Opiate Substitution Treatment/adverse effects/*methods
MH  - Opioid-Related Disorders/epidemiology/psychology/*rehabilitation
MH  - Quality of Life/psychology
MH  - Serologic Tests
MH  - Severity of Illness Index
MH  - Substance Abuse Treatment Centers
MH  - Substance Abuse, Intravenous/epidemiology/psychology/*rehabilitation
MH  - Treatment Outcome
MH  - Young Adult
EDAT- 2011/04/15 06:00
MHDA- 2011/10/28 06:00
CRDT- 2011/04/15 06:00
PHST- 2011/04/15 06:00 [entrez]
PHST- 2011/04/15 06:00 [pubmed]
PHST- 2011/10/28 06:00 [medline]
AID - 10.1111/j.1360-0443.2011.03463.x [doi]
PST - ppublish
SO  - Addiction. 2011 Sep;106(9):1647-55. doi: 10.1111/j.1360-0443.2011.03463.x. Epub 
      2011 Jul 22.