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The
Substance Abuse and Mental Health Services Administration/Center
for Substance Abuse Treatment recently
announced an error in the Treatment Improvement Protocol (TIP) 43:
Medication-Assisted Treatment for Opioid Addiction in Opioid
Treatment Programs. The correction is noted below as it appears
in Chapter 13.
ERRATUM
In
Treatment Improvement Protocol (TIP) 43: Medication-Assisted Treatment
for Opioid Addiction in Opioid Treatment Programs (2005 printing),
Chapter 13, page 219, incorrect information about medication treatment
for neonatal abstinence syndrome (NAS) was published.
Column
1, line 9 from the bottom, reads “0.4 mg/kg/dose.”
It should read “0.4 mg/kg/day.”
Column
1, line 6 from the bottom, reads “0.4 mg/kg/dose.”
It should read “0.04 mg/kg/dose.”
In
subsequent printings of TIP 43, page 219, the paragraphs regarding
this topic have been changed to read:
“If
pharmacological management is indicated, several methods have been
found useful. The American Academy of Pediatrics Committee on Drugs
policy statement on Neonatal Drug Withdrawal (1998) describes several
agents for the treatment of NAS including methadone, tincture of
opium, paregoric, and morphine. One method (J. Greenspan, Thomas
Jefferson University Hospital, Philadelphia, personal communication,
October 2006) uses neonatal opium solution (0.4 mg/mL morphine-equivalent;
starting dosage, 0.4 mg/kg/day orally in six to eight divided doses
[timed with the feeding schedule]). Dosage is increased by 0.04
mg/kg/dose until control is achieved or a maximum of 2.0 mg/kg/day
is reached. If Neonatal Abstinence Scores stay high but daily dosage
nears maximum, symptoms are reassessed and concurrent phenobarbital
therapy considered. When control is achieved, the dosage is continued
for 72 hours before pharmacological weaning, in which dosages are
decreased 10 percent daily or as tolerated. When 0.2 mg/kg/day is
reached, medication may be stopped. Decisions about dosage decrease
during pharmacological weaning are based on Neonatal Abstinence
Scores, weight, and physical exams.”
The
Substance Abuse and Mental Health Services Administration, Center
for Substance Abuse Treatment, regrets any confusion these errors
have caused and asks for your assistance to correct the text in
all copies of the first (2005) printing of TIP 43 to which you have
access. Please help ensure that word of this correction reaches
as many TIP 43 readers as possible.
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Medication-Assisted
Treatment For Opioid Addiction in Opioid Treatment Programs
Click
here to download
For hard copies, please contact SAMHSA's National Clearinghouse
for Drug and Alcohol Information at 1-800-729-6686 or click
here. We encourage every methadone treatment program and
state regulatory oversight office, which has jurisdiction in
this area to obtain as many copies as needed in order to ensure
that all programs have the most current clinical information
available. |
SAMHSA
Releases New Treatment Improvement Protocol (TIP) on Medication
Assisted Treatment for Drug Abuse (October 25, 2005)
The Treatment Improvement Protocol (TIP 43) provides guidance to
treatment providers, physicians and other medical personnel in using
medication assisted treatment for individuals who are addicted to
opiates. It is encouraged that all parties gain access to this valuable
document, which combines four. We are grateful to SAMHSA/CSAT for
their vision in providing the most current information to our treatment
system previously published TIPs on the topic, beginning with the
first TIP, which appeared in 1993 (State Methadone Treatment Guidelines).
It is an extremely informative and well organized document and one
that will assist treatment providers in ensuring that patients are
getting access to the best care possible. For ordering instructions,
please click here.
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SAMHSA's
Press Release
This press
release is clear in underscoring the importance of providing
supportive services, such as counseling, mental health and other
medical services in addition to being certain that the clinicians
understand the basic principles of stabilizing the patient on
therapeutic doses of medication to treat opiate addiction. |
HBO
Documentary Further Stigmatizes Methadone Treatment
The
HBO documentary “Methadonia” follows the lives of eight
people, who are struggling through various stages of their addiction
and treatment. AATOD’s perspective is represented in its Press
Statement of October 3, 2005. AATOD is of the judgment that the
people, who are portrayed in the film, do not represent the majority
of the patients, who are doing well in methadone treatment programs
throughout the country. The majority are working, remaining drug-free
and paying for their own care. These patients hold responsible jobs
and are tax-paying citizens and community members. We are working
with state provider associations, individual program members, patient
advocacy groups and federal and state agencies as a means of responding
to the negative message of this documentary.
Hurricane
Katrina
We
have uploaded several documents to this website with regard to Hurricane
Katrina and the continued treatment of methadone patients in the
affected Gulf States.
We
have worked with patient advocacy groups and treatment providers
since the Hurricane occurred. Many program staff worked extremely
long hours to admit such a large number of patients to their facilities.
A number of state offices, especially in Texas and Louisiana, have
provided great leadership in ensuring that patients will receive
continued treatment until they will be able to return to New Orleans.
We
also know that other programs outside of New Orleans were affected
and we understand that similar arrangements have been made in treating
such patients.
AATOD
will be developing a comprehensive written report to the federal
agencies and State Methadone Authorities.
DEA
Drug Theft and Loss Report
(PDF)
The Drug Enforcement Administration (DEA) released a major report
on the theft and loss of methadone hydrochloride products for calendar
years 2001 through 2003. It is the first time that such information
has been released into the public domain. It provides extremely
useful data about the theft and loss of different methadone products
and represents an extremely useful report for policymakers. Click
here to view report.
Methadone
Associated Mortality Report
This
report was prepared by a panel of federal and state agency officials
and experts in the addiction treatment field clearly documents that
the overwhelming majority of the methadone attributed deaths were
in fact associated with the improper use of methadone as an analgesic
and distributed through pharmacies as opposed to properly medicated
patients receiving comprehensive treatment services in federally
licensed methadone programs. Please read the links below to learn
more about these groundbreaking findings. Click
here to view report.
To
view and print the PDF files listed above, you will require the
Adobe Reader. Click the icon below to download and install the software
for your operating system.
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