Faculty of Medicine
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Item type:Publication, Frequency of cannabis and amphetamine use past month in patients on opioid maintenance treatment with buprenorphine(2024-10-23); ; ; Background Maintenance treatment for opioid use disorder, either with methadone or buprenorphine-based medications, improves retention in the treatment and reduces abuse of illicit opioids. We aimed to examine the cannabis and amphetamine use before and while the treatment with buprenorphine, as well as the correlation of this findings with the demographic characteristics and duration of opioid use disorder. Methods This analytical cross-sectional study was implemented at the Skopje University Clinic for Toxicology. Participants diagnosed with opioid use disorder receiving pharmacological treatment buprenorphine, were asked to self-report the past month cannabis and amphetamine use. Specially for this study designed questionnaire adapted to the “treatment demand indicator” was used to collect the data. Results Тotal of 112 participants (88.39% male and 11.61% female) were enrolled. Before the buprenorphine treatment, cannabis use was permanent in 60 (53.57%), and periodic or not used in 52 (46.43%) participants, and amphetamine use was permanent in 40 (35.71%), and periodic or not used in 72 (64.29%) participants. After the buprenorphine treatment cannabis was not used or used occasionally by 71 (63.39%) of the participants, ones per week or less was used by 14 (12.50%), 2-6 days per week was used by 9 (8.04%), daily used by 6 (5.36%) and unknown by 12 (10.71%) participants, with not significant association with the gender (p=0.732). negative not significant correlation with the age (R=-0.011; p=0.951) and positive not significant correlation with the duration of opioid dependence (R=0.032; p=0.733). Amphetamine after the buprenorphine treatment was not used or used occasionally by 103 (91.96%) participants, used ones per week or less by 6 (5.36%) and 2-6 days per week by 3 (2.68%) participants with significant association of male gender with no use (p=0.009), negative not significant correlation with the age (R=-0.073; p=0.445) and positive not significant correlation with the duration of opioid dependence (R=0.027; p=0.774). Conclusions Before starting treatment of opioid use disorder with buprenorphine, more than half of the patients had a permanent use of cannabis, while more than a third use amphetamines. After initiation of buprenorphine treatment, although some of the patients occasionally use cannabis and amphetamines, the permanent use of these psychoactive substances is reduced. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, The neurophysiological correlates of cognitive functions during methadone and buprenorphine maintenance treatment: The ERP study(AU-CNS, 2021-12); ; Nada Pop-JordanovaBackground. The treatment of opioid dependence with methadone and buprenorphine is equally effective with either of the two drugs, in terms of discontinuation and retention in treatment. Buprenorphine, unlike methadone, is, however, renowned for being a drug that gives a "clear head", which is encouraging for those who are students, or who are, in any case, engaged in intellectual work. Aim. The aim of this study has been to determine if there is a difference in the neurophysiological correlates of cognitive functions in individuals treated with methadone (MMT) versus those treated with buprenorphine (BMT). Methods. The study includes 10 participants belonging to the MMT group and 10 others involved in the BMT group; both these study groups were compared with the control group after matching had been carried out for age and gender. Brain activity was recorded with the QEEG Mitsar system while study participants were performing two neuropsychological tasks. The VCPT and ECPT as modifications of the Go/NoGo paradigm were applied in order to obtain cognitive event-related potentials (ERPs) as indexes of executive functions. Besides the behavioural parameters of test performance, amplitude and latency of CNV, Cue P3, P3 Go, P3NoGo, N2Go and N2 NoGo were explored at Fz, Cz and Pz, reflecting different stages of information processing. Results. The MMT group showed longer latencies of the ERP components, and the BMT participants showed slightly better results than those of the MMT group. Still, most of the parameters did not differ significantly from those of the control group. Behavioural parameters showed significantly higher values for variables in the results for reaction time and the number of errors of omission and commission found in the competing MMT vs BMT groups, as well as the control group. Conclusions. Neurophysiological evidence suggests that methadone and buprenorphine both have positive effects on neurophysiological functions, as fewer abnormalities were found in MMT or BMT patients than in healthy controls. It has been shown that the sensitivity and specificity of detecting drug effects increase significantly when adding neurophysiological measures to task performance. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Physical birth outcomes in neonates prenatally exposed to buprenorphine – our first experiences(2019-09-17); ; Introduction/Objective Buprenorphine appears generally similar to, and in some cases superior to, methadone in terms of maternal, fetal, and neonatal outcomes. The objective of the study was to assess some physical birth outcomes in neonates prenatally exposed to buprenorphine. Methods During a seven-year period, nine patients have been treated with buprenorphine during their pregnancy. All women underwent interview, clinical investigations, biochemical analysis, toxicological screening, viral markers for hepatitis B, C, HIV, with regular check-ups by an obstetrician and a psychiatrist. Newborn outcomes included: birth weight in grams, birth length in centimeters, physical anomalies, head/chest circumference in centimeters, Apgar score at 1 minute / 5 minutes, gestational age (weeks), newborn length of hospital stay in days, breast-feeding, the newborn’s need for pharmacologic treatment after delivery. Results The mean birth weight was 2,991.11 ± 37 g; birth length was 49.44 ± 2.29 cm; head circumference was 33.11 ± 0.78 cm; chest circumference was 32.33 ± 1 cm; first minute Apgar score was 8.22, fifth minute 9.22; age at delivery was 38.77 ± 1.09 weeks; hospitalization after delivery 4.44 ± 1.13 days. None of the newborns had physical anomalies. Six of the newborns were breastfed. Conclusion Buprenorphine is a safe and important part of a complete comprehensive treatment approach in pregnant women with opioid use disorder. Buprenorphine treatment of maternal opioid use disorder indicated a low risk of preterm birth, normal birth weight and length, head and chest circumference, Apgar score, short hospitalization after delivery.