Nursing Nuggets >> Mental Health Nursing >> methadone titration, how quick do your teams do it?
methadone titration, how quick do your teams do it?
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Posted over 2 years ago just wondering really, if theres a difference between the speed you guys titrate methadone? where i am, a 'new' client would start 20ml 1st day then 30ml for the next 6 days then 10ml increases weekly. orange book guidelines say ' there are lots for fors and against. but if someone is motivated enough to get into treatment, and i do mean 'get into treatment' not sustitute-my-habit-so-i-dont-have-to-buy-as-much-but continue-to-use-on-top. shouldnt there be more efforts to get them on a stable dose asasap (as soon and safely as possible). what'd you guys think?
'Titrate the calculated dose against any continuing withdrawal symptoms', as such these remain guidelines. |
8 posts back to top |
| Posted over 2 years ago I work in a community addiction team and we always start people on 30mls of methadone, then titrate by 10mls every 3 days until they reach a therapeutic dose, thats the quickest we would do it at the start and then normally they are seen weekly and increased by 10mls weekly until stable. |
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| Posted about 1 year ago our consultant provides an initial 30ml for 2 days and increases to 40mls for the rest of the week and then 10 ml eekly increases untill optimal dose reached for that client. |
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| Posted about 1 year ago I have worked at various Specialist Addictions Units in the UK for the last six years. We would titrate as appropriate, clients on high dose's of heroin can be started on 50ml if evidence of withdrawel and knowelege of levels of use (previous prescribing history + reported levels of use + positive drug screening) you can then jump up to 20ml the second day and a further 10 the day after (This would be done Wednesday to Friday for example), a short stablisation of 3 days (over the weekend) followed by further titration as appropriate (usually 5mls a day but sometimes 10)
Most clients can be stablised on a holding dose in 3 days this way, this minimises the discomfort, reduces the chance of on top use increasing tolerance and improves retention. Even clients using alcohol and benzo's can be managed this way as long as the risks are discussed and managed. balance this with giving a patient using say 1g heroin + a day 30ml, which doesn't hold them, the patient has to score illicit drugs to stay 'well' this means maintaining contacts with other drug users, probably coming into contact with crack as well and the need to possibly engage in illegal activity to fund this continued use will they bother to come back to your service? which is the greatest risk to the client, 50ml or having to inject street heroin?
The Orange Guidelines state that clinical judgement should be used, anyone refusing to adapt their titration to the client is an idiot who's service probably has a bad reputation and only attracts people in desperation as a last resort :( |
2 posts back to top |
| Posted 4 months ago This question could be better answered by professionals working for long time in quality treatment centers like California drug rehabilitation. Methadone is effective in curing addiction; but there are certain complicated issues involved with this treatment. This issues could only be handled by professionals associated with this treatment procedure. |
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| Posted 4 months ago Although methadone is used in treating addiction problems, but you can develop an addiction to it. So it is better to visit a drug rehab like Drug rehab Phoenix where you can ask about the proper use of methadone. They would be able to guide you about the appropriate usage of this medicine and also could warn you about side effects. |
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| Posted 4 months ago In drug rehabs apply methadone is a known fact. But care should be taken while taking this as it may have some side effects. Drug rehabs treat each patient individually. It is better to go for a holistic drug rehab where an overall approach is taken to treat a patient back to normal life. |
