Long-term methadone maintenance reduces protracted symptoms of heroin abstinence and cue-induced craving in Chinese heroin abusers.
BACKGROUND
Cession of heroin use may be followed by a protracted-abstinence (PA) syndrome consisting of craving, negative mood, and physiological changes. PA symptoms have rarely been compared between drug-free and methadone-maintained former heroin users after similar lengths of heroin abstinence.


METHODS
Seventy former heroin users were included in one of four groups: in day 15-45 of methadone maintenance therapy (short-term MMT), in month 5-6 of MMT (long-term MMT), opiate-free for 15-45 days after methadone-assisted heroin detoxification (short-term post-methadone), and opiate-free for 5-6 months after methadone-assisted heroin detoxification (long-term post-methadone). PA symptoms (negative mood, dyssomnia, somatization, and craving), and blood pressure and pulse were assessed pre- and post-neutral videotape and pre- and post-heroin videotape.


RESULTS
Dyssomnia and the total PA score were worst in short-term post-methadone participants, mood was best in long-term MMT participants, and cue-induced craving was least severe in long-term MMT participants. Blood pressure and pulse did not differ across groups.


CONCLUSIONS
Even after acute withdrawal, the first months of heroin abstinence after methadone-assisted detoxification may be more difficult in terms of cue-induced craving and other PA symptoms than the first months of heroin abstinence during MMT. Our findings add to the literature supporting MMT for prevention of cue-induced heroin craving.
Shi
Jie
J
Department of Clinical Pharmacology, National Institute on Drug Dependence, Peking University, Beijing 100083, China.
Zhao
Li-Yan
LY
Epstein
David H
DH
Zhang
Xiao-Li
XL
Lu
Lin
L
D000328:Adult; D001794:Blood Pressure / Q000187:drug effects; D002681:China; D003463:Cues; D006339:Heart Rate / Q000187:drug effects; D006556:Heroin Dependence / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use*; D019964:Mood Disorders / Q000209:etiology / Q000523:psychology; D009294:Narcotics / Q000627:therapeutic use*; D010775:Photic Stimulation; D012893:Sleep Wake Disorders / Q000209:etiology / Q000523:psychology; D013001:Somatoform Disorders / Q000209:etiology / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000523:psychology*
D009294:Narcotics; D008691:Methadone