title: Self-reported cravings for heroin and cocaine during maintenance treatment with slow-release oral morphine compared with methadone: a randomized, crossover clinical trial.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  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).
  
  
  RESULTS
  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 P < 0.0001, HCQ P = 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 P = 0.175, CCQ P = 0.536). No significant carry-over effects were detected.
  
  
  CONCLUSIONS
  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.
authors: From the *Arud Centers for Addiction Medicine, Zurich, Switzerland; and †Center for Interdisciplinary Addiction Research, University of Hamburg, Hamburg, Germany.
authors: Luis
authors: L
authors: Falcato
authors: Thilo
authors: T
authors: Beck
authors: Jens
authors: J
authors: Reimer
authors: Uwe
authors: U
authors: Verthein
mesh_terms: D000328:Adult; D019970:Cocaine-Related Disorders / Q000523:psychology* / Q000534:rehabilitation*; D018592:Cross-Over Studies; D005260:Female; D006556:Heroin Dependence / Q000523:psychology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage / Q000627:therapeutic use*; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use*; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment / Q000523:psychology; D013375:Substance Withdrawal Syndrome / Q000523:psychology*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D009294:Narcotics; D009020:Morphine; D008691:Methadone