Journal of addiction medicine
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This case report aims to help healthcare providers and methadone clinic patients to recognize one of the less recognized adverse effects of methadone, hyperhidrosis, and to suggest oxybutynin as a possible solution. ⋯ Methadone-induced excessive sweating is an adverse effect of the medication that reportedly affects up to 45% of those prescribed methadone, and oxybutynin is a potent treatment for methadone-induced excessive sweating.
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The prevalence of opioid use disorder (OUD) during pregnancy is increasing. Practical recommendations will help providers treat pregnant women with OUD and reduce potentially negative health consequences for mother, fetus, and child. This article summarizes the literature review conducted using the RAND/University of California, Los Angeles Appropriateness Method project completed by the US Department of Health and Human Services Substance Abuse and Mental Health Services Administration to obtain current evidence on treatment approaches for pregnant and parenting women with OUD and their infants and children. ⋯ Women with OUD can be treated with methadone or buprenorphine during pregnancy. NAS is an expected and manageable condition. Although research has substantially advanced, opportunities to guide future research to improve maternal and infant outcomes are provided.
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Case Reports
When the Laughing Stops: Subacute Combined Spinal Cord Degeneration Caused by Laughing Gas Use.
: Here we describe a case of subacute combined spinal cord degeneration caused by nitrous oxide (N2O, laughing gas) use. Because of its euphoric effects, the use of N2O has become increasingly popular in recent years. Unfortunately, the use of N2O leads to inactivation of vitamin B12. ⋯ Treatment with intramuscular vitamin B12 injections and abstinence of N2O generally leads to gradual improvement of symptoms. Our case demonstrates the importance of the methyl malonic acid test to detect early or mild vitamin B12 deficiency as a cause of myelopathy while serum vitamin B12 level may be normal. Written consent was obtained from our patient to publish the details of this individual case.