[Slow-release morphine hydrochloride for maintenance therapy of opioid dependence].
BACKGROUND
In Austria, methadone, buprenorphine as well as oral slow-release morphine are used for the treatment of opioid dependence. This controlled examination marks the first time that oral slow-release morphine hydrochloride is applied for maintenance therapy in opioid dependent subjects.


METHODS
In order to evaluate the effectiveness of this psychopharmacological medication, we examined patients over a three-week period. Outcome measures were retention rate, additional consumption and the evaluation of opioid withdrawal 24 hours after the last oral medication.


RESULTS
Sixty-seven patients were included; sixty-four patients completed the study, representing a retention rate of 94%. During the three-week period, a significant improvement in well-being and a significant reduction in heroin, cocaine and benzodiazepine craving (p < 0.0001) was evaluated. Furthermore, there was a significant reduction of additional consumption of benzodiazepines in supervised urinalysis. Additional consumption of cocaine remained unchanged. Laboratory results showed a significant reduction of CK over the course of investigation.


CONCLUSIONS
The high retention rate of 94% implies a good acceptance and efficacy of the substance. The reduced CK is consistent with a reduction in intravenous application of illegal substances. However, randomized double-blind, double-dummy studies with oral slow-release morphine are needed in order to meet criteria for evidence based medicine.
Kraigher
Dominik
D
Abteilung für Sozialpsychiatrie und Evaluationsforschung, Universitätsklinik für Psychiatrie des AKH Wien, Osterreich.
Ortner
Romana
R
Eder
Harald
H
Schindler
Shird
S
Fischer
Gabriele
G
D000328:Adult; D000428:Alcohol Drinking; D000469:Alkaline Phosphatase / Q000097:blood; D000704:Analysis of Variance; D002784:Cholesterol / Q000097:blood; D002802:Cholinesterases / Q000097:blood; D019970:Cocaine-Related Disorders / Q000175:diagnosis; D003402:Creatine Kinase / Q000097:blood; D003627:Data Interpretation, Statistical; D003692:Delayed-Action Preparations; D003863:Depression / Q000175:diagnosis; D005260:Female; D006556:Heroin Dependence / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D009293:Opioid-Related Disorders / Q000097:blood / Q000175:diagnosis / Q000534:rehabilitation*; D012964:Sodium / Q000097:blood; D013997:Time Factors; D016896:Treatment Outcome
D003692:Delayed-Action Preparations; D009020:Morphine; D002784:Cholesterol; D012964:Sodium; D003402:Creatine Kinase; D002802:Cholinesterases; D000469:Alkaline Phosphatase