Undesirable effects of substitution medications in treating opioid addicts
Substitution treatment, usually with methadone or buprenorphine, is the treatment of choice for opioid dependence. These medications have to be taken over extended periods of time, if not for life. They may have undesirable effects that can have an impact on the quality of life of some patients, requiring the involvement of health professionals in the treatment. This article will review the following undesirable effects: male hypogonadism, QT interval prolongation, neonatal withdrawal syndrome, lung function test anomalies, hyperalgesia, risk of intoxication, medication abuse, drug interactions. Substitution treatment is also associated with a number of regulatory constraints that, while they may be pertinent early in the treatment, may become a burden and inappropriate for patients who have been stable for several years. Being ready to listen and properly manage these undesirable effects is indispensable in making the treatment acceptable and attractive for users.