DINO-VAMP: A Helpful Acronym in Determining Optimal Methadone Dosing and Brief Review of Dosing Literature

Methadone clinics commonly provide inadequate methadone doses for patients in treatment resulting in continuing heroin use and high risk activities. In order to optimize methadone dosing to achieve opiate “blockade,” it has become our policy to apply an acronym, DINO-VAMP, to interview heroin using patients. By asking about the areas represented by each letter, providers can identify and manage issues relating to methadone dosing in a systematic, user-friendly manner. D for drug use and dose, I for drug Interactions, N for neuroleptic (psychiatric) issues, O for opiate withdrawal symptoms, V for vitamin C and hepatitis C, A for home atmosphere (stress), M for menopause and medical issues and P for pregnancy and plasma methadone level allowing providers to cover all major significant areas related to methadone dosing. The clinic that applies this acronym demonstrates repeatedly a 30% lower heroin positivity than others using the same system.