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Effects - Methadone Metabolism in the Elderly

Discussion in 'Methadone' started by Spucky, Jan 19, 2011.

  1. Spucky

    Spucky Palladium Member

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    Question:

    Do a Swiny have accurate Data about the Methadone Metabolism from MMT-Patients
    who are older than 50?

    How much slower the Methadone get metabolized?
    What is/will be a dangerous Plasma-Level?

    How is the Combination of HCV and a old Age?

    I am asking this because of a increasing number of Death in the elderly MMT Patients
     
    Last edited: Jan 19, 2011
  2. masonicboom

    masonicboom Newbie

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    The methadone deaths are simply part of taking methadone and not age related.
    Age is not a factor in metabolization.
     
  3. Jatelka

    Jatelka Psychedelic Shepherdess Platinum Member & Advisor

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    Although metabolism has not been specifically studeied in the elderly (that I'm aware of), we can make certain inferences from what we know about the metabolism of methadone and age related changes that occur in the body

    Methadone is metabolised by the Cytochrome p450 system (CYP3A4, CYP2B6, and CYP2C19 and to a lesser extent CYP2C9 and CYP2D6), there is some evidence that these enzymes are less effective with advancing age. There are also changes that occur to hepatic blood flow with age

    Older people have less total body water:fat ratio than younger people, Methadone is a lipohilic drug, so there is potentially a higher distribution volume in the elderly (that is, total body concentrations)

    Methadone and metabolites are excreted by the kidneys, and kidney function drops off with age (although not appreciably by age 50), so theoretically, they could accumulate

    Taking all of that into account, I think it's a fairly safe bet that older people require smaller doses of Methadone, spaced further apart, and are more likely to experience adverse effects from a given dose (as with many other drugs, including Benzodiazepines)

    I think this is a fascinating topic, and one that will become more and more relevent as the drug-using population ages

    So the statement that age is not a factor is untrue
     
  4. Spucky

    Spucky Palladium Member

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    AW: Methadone Metabolism in the Elderly

    I upload the complete Opioid Metabolism for a better understanding!
    (it is from a nice Webpage who offer a lot for Free)

    So, what is happen when the Patients getting older while they are in a MMT?
    Do the Tolerance increase slowly while the Metabolism is decreasing
    or is there a "Point of no Return"?

    Why some (a relevant amount of...) "elderly steady state" Patients die "suddenly" from a Methadone-OD
    without a/the cooperation of other Drugs like Alcohol or/and Benzos?

     
    Last edited: Jan 26, 2011
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