Comparison of tincture of opium and methadone to control opioid withdrawal in a Thai treatment centre.
OBJECTIVE
To evaluate the effectiveness of oral tincture of opium (TOP) and methadone to control opioid withdrawal in patients in northern Thailand.


METHODS
Open label, parallel group study in an inpatient facility compared 15 former heroin users receiving methadone 5-20 mg 12 hourly with 15 former opium smokers receiving TOP (3.33-10 mg morphine equivalents 12 hourly). At 0, 1, 3 and 8 h, blood, withdrawal scores and subjective opioid effects were collected.


RESULTS
There was a reciprocal association between withdrawal scores/direct subjective opioid effects and plasma (R)-methadone, but not plasma morphine, concentrations. Withdrawal scores at the time of dosing were higher in the TOP patients (9.1 +/- 3) than in the methadone patients (4.5 +/- 4.6) and in the TOP patients were significantly (P = 0.001) attenuated at 3 and 8 h.


CONCLUSIONS
At the doses used, TOP was inferior to methadone in suppressing withdrawal. It could prove to be a cost effective and valuable drug, but only after dose size and frequency are further investigated.
Jittiwutikarn
Jaroon
J
Northern Drug Dependence Centre, Chiang Mai Province, Thailand.
Ali
Robert
R
White
Jason M
JM
Bochner
Felix
F
Somogyi
Andrew A
AA
Foster
David J R
DJ
D000284:Administration, Oral; D000328:Adult; D006801:Humans; D008691:Methadone / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000097:blood; D009294:Narcotics / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000097:blood / Q000534:rehabilitation*; D009892:Opium / Q000627:therapeutic use*; D013375:Substance Withdrawal Syndrome / Q000097:blood / Q000517:prevention & control*
D009294:Narcotics; D009020:Morphine; D009892:Opium; D008691:Methadone