Articles – Opioid Treatment Program

SAM in MMT (Substance-Abuse Monitoring in Methadone Maintenance Treatment)

This article published by Addiction Treatment Forum in 2005, discusses the role of substance abuse monitoring during methadone maintenance treatment.

The following articles are in response to the issue raised at the October OTP monthly phone call on safe driving and methadone treatment:

1. Methadone and impairment in apprehended drivers

Bernard, J., Morland, J., Krogh, M., & Khiabani, H. (2009). Methadone and impairment in apprehended drivers. Addiction, 104 (3), 457-464.

Bernard, Morland, Krogh & Khiabani explore apprehended drivers who had methadone in their blood at the time of apprehension and the relationship between blood methadone concentration and impairment, measured by the clinical test of impairment (CTI).  The conclusion is that cases involving driving impairment were rare when involving methadone alone and that combination use was the most frequent cause for impaired driving.  There was no correlation in the relationship between blood methadone concentration and impairment.

2. Influence of peak and trough levels of opioid maintenance therapy on driving aptitude

Baewart, A., Gombas, W., Schindler, S., Peternell-Moelzer, A., Eder, H., Jagsch, R., & Fisher, G. (2007). Influence of peak and trough levels of opioid maintenance therapy on driving aptitude. European Addiction Research, 13(3), 127-135.

The standardized Act and React Testsystem (ART) was used to measure traffic-relevant performance at peak and trough medication levels in opioid-dependent patients receiving maintenance therapy with either buprenorphine or methadone and a medication-free control group.  Although, the findings showed that patients had a higher percentage of incorrect reactions and simple errors at trough levels than patients at peak levels, there was not significant data showing that these substances affect traffic-relevant performance.

3. Maintenance therapy with synthetic opioids and driving aptitude

Schindler, S., Ortner, R., Peternell, A., Eder, H., Opgenoorth, E., & Fischer, G. (2004). Maintenance therapy with synthetic opioids and driving aptitude. European Addiction Research, 10(2), 80-87.

The study included 30 opioid dependant patients maintained on either methadone or buprenorphine and were compared to a healthy control group in the standardized Act and React Testsystem (ART).  The results show that there is not a significant difference in results between the methadone-maintenance or buprenorphine-maintenance and the healthy control group.

4. The effects of the opioid pharmacotherapies methadone, LAAM and buprenophine, alone and in combination with alcohol, on stimulated driving

Lenne, M., Dietze, P., Rumbold, G., Redman, J., & Triggs, T. (2003) The effects of the opioid pharmacotherapies methadone, LAAM and buprenorphine, alone and in combination with alcohol, on stimulated driving.  Drug and Alcohol Dependence, 72(3), 271-278.

The purpose of this study was to measure the effects of methadone, LAAM or buprenorphine used in maintenance therapy for opioid dependent individuals, upon stimulated driving.  The conclusions showed that there was no significant difference among these groups or the control group.

5. Cognitive-motor performance of methadone-maintained patients

Specka, M., Finkbeiner, T., Lodemann, E., Leifert, K., Kluqig, J., & Gastpar, M. (2000). Cognitive-motor performance of methadone-maintained patients. European Addiction Research, 6(1), 8-19.

The study involved 54 methadone-maintained patients and 54 healthy controls and used 6 measurement outcomes to look at cognitive-pyschomotor performance.  The conclusions stated that assessment of fitness for certain tasks or occupations should be determined on an individual basis.  It was also concluded that methadone use should not be used as a predictor of cognitive-psychomotor impairment.


A Project of the Governor's Institute on Alcohol & Substance Abuse and the North Carolina Society of Addiction Medicine.
Funded wholly or in part by the federal Substance Abuse Prevention and Treatment Block Grant Fund (CFDA #93.959) as a project of the NC Division of Mental Health, Developmental Disabilities & Substance Abuse Services.