Self-Reported Cravings for Heroin and Cocaine During Maintenance Treatment With Slow-Release Oral Morphine Compared With Methadone. Issue 2 (April 2015)

• Record Type: Journal Article
• Authors: Falcato, Luis; Beck, Thilo; Reimer, Jens; Verthein, Uwe
• Is Part Of: Journal of clinical psychopharmacology. Volume 35:Issue 2(2015)
• Publication Date: 2015-04
• Subjects: Psychopharmacology -- Periodicals; Psychopharmacology -- Periodicals; Psychopharmacologie -- Périodiques; Psychopharmacology; Periodicals; 615.78
• DOI: 10.1097/JCP.0000000000000288
• Languages: English
• ISSNs: 0271-0749

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <sec> <title>Objective</title> <p>Craving, an urge or increased desire to take a drug, is part of a cluster of behavioral, cognitive, and physiological phenomena that can develop after substance use. Self-reported cravings for heroin and cocaine are compared in opioid dependent patients while receiving maintenance treatment with slow-release oral morphine (SROM) or methadone.</p> </sec> <sec> <title>Methods</title> <p>Data from a 22-week open-label, randomized, crossover trial (per protocol sample n = 157) were examined by analysis of variance (ANOVA). Cravings for heroin and cocaine during the past 7 days were assessed at baseline and thrice during each 11-week treatment period using a Visual Analog Scale (heroin, VAS-H; cocaine, VAS-C), German versions of the brief Heroin Craving Questionnaire (HCQ), and the brief Cocaine Craving Questionnaire (CCQ).</p> </sec> <sec> <title>Results</title> <p>Mean (SD) heroin craving scores under methadone were 3.3 (2.4) (VAS-H) and 2.9 (1.4) (HCQ). Heroin craving scores under SROM were significantly lower, at 2.5 (2.2) (VAS-H) and 2.6 (1.2) (HCQ) (ANOVA: VAS-H <italic>P</italic> < 0.0001, HCQ <italic>P</italic> = 0.010). Cocaine craving scores were not significantly different (methadone: 1.6 (2.0) (VAS-C) and 2.1 (1.2) (CCQ) vs SROM: 1.4 (1.9) (VAS-C) and 2.1 (1.2) (CCQ); ANOVA: VAS-C <italic>P</italic> = 0.175, CCQ <italic>P</italic> = 0.536). No significant carry-over effects were detected.</p> </sec> <sec> <title>Conclusions</title> <p>This study demonstrates that SROM is clinically more effective than methadone in reducing general craving for heroin during opioid maintenance treatment while not affecting cocaine craving.</p> </sec> </abstract>