Weight Gain Among the Patients in Methadone Maintenance Program as Come-back to Population Norm
Authors:
Ľ. Okruhlica; S. Slezáková
Authors‘ workplace:
Centrum pre liečbu drogových závislostí, Bratislava
Published in:
Čas. Lék. čes. 2008; 147: 426-430
Category:
Original Article
Overview
Background.
Clinical experience reveals a weight increase among patients with opiate dependence after their admission to methadone maintenance treatment (MMT). The objective of the present study was to find out whether there was a significant weight increase among MMT patients, and if so, to what extent this change in weight differed from the existing statistical norm of the general population.
Methods and Results.
The sample consisted of 274 MMT patients of the CPLDZ Bratislava with the average age of 26.3 years, 69% were males. Only those patients were included into the study that had stayed in MMT for at least one year. Two main comparisons of their body mass index (BMI) were done: 1. at entry into MMT, and one year after entry; 2. a comparison of BMI one year after treatment entry with BMI of the general Slovak population. Underweight was present in 10% of the patients entering MMT, 72% had BMI within a normal range, 15% were overweight, and 3% were obese. A significant shift towards higher BMI categories was reported one year after treatment entry: 5%, 58%, 29% and 8%, respectively (p < 0.001), which is still significantly lower than in the general population: 4%, 49%, 34% a 13% (p < 0.001).
Conclusions.
Our results indicate that weight increase in MMT patients should not be considered a direct side-effect, because it is not possible to differentiate between a drug effect and changed behavioural eating stereotypes that could be identical to those in the general population.
Key words:
methadone maintenance treatment, methadone substitution, overweight, obesity, drug side-effects, BMI.
Sources
1. Schwartz, T. L., Nihalani, N., Jindal, S. et al.: Psychiatric medication-induced obesity: a review. Obes. Rev., 2004, 5, s. 115–121.
2. Ruetsch, O., Viala, A., Bardou, H. et al.: Psychotropic drugs induced weight gain: a review of the literature concerning epidemiological data, mechanisms and management. Encephale., 2005, 31, s. 507–516.
3. Zimmermann, U., Kraus, T., Himmerich, H. et al.: Epidemiology, implications amd mechanisms underlying drug-induces weight gain in psychiatric patients. J. Psychiatr. Res., 2003, 37, s. 193–220.
4. Weiden, P. J.: Switching antipsychotics as a treat,ment strategy for antipsychotic-induced weight gain and dyslipidemia. J. Clin. Psychiatry., 2007, 68 (Suppl. 4), s. 34–39.
5. Kábrt, J., Wilczek, H., Svobodová, J. et al.: Nutriční stav toxikomanů v metadonovém programu. Čas. Lék. čes., 1999, 138, s. 639–695.
6. Szpanowska-Wohn, A., Kolarczyk, E., Pach, D., Targosz, D.: Nutritional status of opiate-dependent persons before and during methadone maintenance therapy. Przegl. Lek., 2004, 61, s. 339–344.
7. Wilczek, H., Haluzík, M., Svobodová, J., Pařízková, J.: Sérové koncentrace leptinu u osob závislých na heroinu, vliv roční substituce metadonem. Vnitř. Lék., 2004, 50, s. 282–285.
8. Kolarzyk, E., Pach, D., Szpanowska-Wohn, A., Szurkowska, M.: Nutriotional status of the opiate dependent persons after 4 years of methadone maintenance treatment. Przegl. Lek., 2005, 62, s. 373–377.
9. Nollan, L. J., Scagnelli, L. M.: Preference for sweet foods and higher body mass index in patients being treated in long-term methadone. Subst. Use Misuse, 2007, 42, s. 1555-1566.
10. Zhang, M., Gosnell, B. A., Kelley, A. E.: Intake of high-fat food is selectively enhanced by mu opioid receptor stimulation within the nucleus accumbens. J. Pharmacol. Exp. Ther., 1998, 285, s. 908–914.
11. Zhang, M., Kelley, A. E.: Intake of sachcarin, salt, and ethanol solutions is increased by infucion of a mu opioid agonist into nucleus accumbens. Psychopharmacology (Berl), 2002, 159, s. 415–423.
12. Will, M. J., Pratt, W. E., Kelley, A. E.: Pharmacological characterization of high-fat eating induced by opioid stimulation of the ventral striatum. Physiol. Behav., 2006, 89, s. 226–234.
13. Olszewski, P. K., Levine, A. S.: Central opioids and consumption of sweet tastants: when reward outweighs homeostasis. Physiol. Behav., 2007, 91, s. 506–512.
14. Szpanowska-Wohn, A., Kolarczyk, E., Kroch, S., Janik, A.: Nutritional problems of persons qualified for methadone treatment. Pert I. Nutritional status of opiate addicts. Przegled. Lek., 2000, 57, s. 539–543.
15. Atkinson, R. L.: Oidpio regulation of food intake and body weight in humans. Fed. Proc., 1987, 46, s. 178–182.
16. Fatino, M: Endogenous opiates, palatability and control of food intake. Ann. Endocrinol., 1988, 49, s. 125–332.
17. Levine, A. S., Morley, J. E., Gosnell, B. A. et al.: Opioids and consumatory behavior. Brain. Res. Bull., 1985, 14, s. 663–672.
18. Kleiner, K. D., Gold, M. S., Frost-Pineda, K. et al.: Mass Index and Alcohol Use. J. Addict. Dis., 2004, 23, s. 105–119.
19. Warren, M., Frost-Pineda, K., Gold, M.: Body mass index and marijuana use. J Addict Dis., 2005, 24, s. 95–100.
20. Bothing, S.: WHO MONICA Project: Objectives and design. Int. J. Epidemiol., 1989, 18 (Suppl. 1), s. 529–537.
21. Baráková A. et al.: Monika SR, ÚZIŠ, 2002 (nepublikované).
22. Gamber, S. E., Clarke, J. A.: Comments on dietary intake of drug-dependent persons. J. Am. Diet. Assoc., 1976, 68, s. 155–157.
23. Hodgkins, C. C., Cahill, K. S., Seraphine, A. E. et al.: Adolescent drug addiction treatment and weight gain. J. Addict. Dis., 2004, 23, s. 55–65.
24. Mizoue, T., Ueda, R., Tokui, N. et al.: Body mass decrease after initial gain following smoking cessation. Int. J. Epidemiol., 1998, 27, s. 984–988.
25. John, U., Meyer, C., Rumpf, H. J. et al.: No considerable long-term weight gain after smoking cessation: evidence from prospective study. Eur. J. Cancer Prev., 2005, 14, s. 289–295.
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Addictology Allergology and clinical immunology Angiology Audiology Clinical biochemistry Dermatology & STDs Paediatric gastroenterology Paediatric surgery Paediatric cardiology Paediatric neurology Paediatric ENT Paediatric psychiatry Paediatric rheumatology Diabetology Pharmacy Vascular surgery Pain management Dental HygienistArticle was published in
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