title: Cocaine and morphine interaction in acute and chronic cancer pain.
abstract: An evaluation of the analgesic, mood and side effects of the combination of intramuscular morphine and oral cocaine was conducted in 17 patients with postoperative pain and 19 others with chronic malignant pain for the purpose of assessing the therapeutic merits of so-called 'euphoriant' elixirs in the management of pain in cancer patients. The study was designed as a randomized and double-blind single dose but complete cross-over comparison of the combination of 10 mg intramuscular morphine and 10 mg oral cocaine with morphine alone, cocaine alone, and placebo. While patients clearly discriminated between the analgesic effects of morphine and placebo, there were no differences in the analgesic responses to cocaine and placebo, or in responses to morphine and the combination of morphine and cocaine in either patient group. Side effects were predominantly morphine-like and occurred in 59% of patients after the combination, 43% after morphine, 34% after cocaine and 25% after placebo. Interaction effects between cocaine and morphine were observed in terms of positive changes toward selected aspects of mood (e.g., cheerful, friendly) in postoperative patients but toward negative aspects of mood (e.g., sad, serious) in patients with chronic pain.
authors.affiliation: Purdue Frederick Co., Norwalk, CTU.S.A. Albert Einstein College of Medicine, Bronx, NYU.S.A. Analgesic Studies Section and Pain Service, Memorial Sloan-Kettering Cancer Center, New York, NYU.S.A. Cornell University Medical College, New York, NYU.S.A.
authors.forename: Robert F
authors.initials: RF
authors.lastname: Kaiko
authors.forename: Ronald
authors.initials: R
authors.lastname: Kanner
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Foley
authors.forename: Stanley L
authors.initials: SL
authors.lastname: Wallenstein
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Canel
authors.forename: Ada G
authors.initials: AG
authors.lastname: Rogers
authors.forename: Raymond W
authors.initials: RW
authors.lastname: Houde
mesh_terms: D000328:Adult; D000368:Aged; D002986:Clinical Trials as Topic; D003042:Cocaine / Q000009:adverse effects / Q000627:therapeutic use*; D004311:Double-Blind Method; D004357:Drug Synergism; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000009:adverse effects / Q000627:therapeutic use*; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D010149:Postoperative Pain / Q000188:drug therapy; D011897:Random Allocation
chemical_list: D009020:Morphine; D003042:Cocaine