Optimisation of methadone treatment in a group of patients on a mephedrone binge and dependent on many psychoactive substances

Abstract

Objectives: In recent years, an increase in the frequency of hospitalisations of patients on a mephedrone binge has been observed. The literature lacks data on the optimisation of methadone treatment in this group of people.

Methods: The study included 601 patients who took mephedrone on a regular basis between 2010 and 2018. Based on the pharmacological database created, it was verified which methadone interaction contributed to subsequent hospitalisations in the group of people studied and which of them had the best therapeutic effect.

Results: During the study, 62.4% of patients received methadone (p < .001). The higher the number of drugs taken together with methadone, the higher the frequency of hospitalisations (p < .001). The highest frequency of re-hospitalisations was recorded in patients who combined mephedrone with at least two other psychoactive substances, as well as those who used methadone with chlorprothixene (p < .001). The most optimal therapeutic effect is characteristic for the intake of methadone with thiazolidine carboxylic acid, namely 95% of people using this type of treatment were hospitalised once (p < .001).

Conclusions: Therapy with methadone and thiazolidine carboxylic acid seems to be the most optimal therapy for patients taking mephedrone.

Key points

• The number of hospitalisations of patients receiving mephedrone on a regular basis grows from year to year.

• The multiple use of poly-pharmacotherapy increased in a group of patients on a mephedrone binge.

• There is a statistically significant correlation between the number of hospitalisations of patients on a mephedrone binge and the total number of drugs taken together with methadone.

• Administration of methadone with thiazolidine carboxylic acid was the most effective therapy for patients regularly combining mephedrone with at least two other psychoactive substances.

Keywords:

• Methadone
• mephedrone
• thiazolidine carboxylic acid

Acknowledgements

The authors specially acknowledge Tadeusz Nasierowski, MD, PhD for making this research possible.

Author contributions

M.O. conceived and proposed the idea; M.O. designed, wrote and revised the manuscript; M.E. analysed pharmacological database for drug-drug interactions in context of the researched group; T.N., M.E. and M.B.Z. revised the manuscript. All authors have read and approved the final manuscript.

Disclosure statement

The authors have no conflicts of interest, and the work was not supported or funded by any drug company.

Availability of data and materials

All data generated or analysed during this study are included in this published article.