Effect of Methadone Maintenance Treatment on Heroin Craving, a Literature Review

Abstract

Despite agreement that methadone maintenance treatment (MMT) is an effective and safe option for treatment of heroin dependence, there have been controversies about its effect on heroin craving. A systematic literature review of the PubMed database was used to find studies eligible for inclusion in the study. The authors present the results of 16 articles that met all inclusion criteria. Overall, 7 studies reported that methadone could reduce heroin craving, 4 studies reported that patients in MMT are still at risk of having heroin craving, 1 study reported that methadone could increase heroin craving, and 4 studies reported that methadone has a neutral effect on heroin craving. One may speculate from these data that methadone may help with heroin craving, but patients in MMT may still be at risk of cue-induced heroin cravings. Methadone provides a helpful tool for reducing some components of craving and risk of relapse for patient receiving MMT.

Familial expressed emotion among heroin addicts in methadone maintenance treatment: Does it matter?

“…Solid evidence has consistently indicated that MMT is an effective treatment for opiate dependence (Fareed et al, 2011;Farrell et al, 1994;Garrido & Troconiz, 1999;Joseph, Stancliff, & Langrod, 2000), and longer retention time has been consistently associated with better outcomes (Flynn, Joe, Broome, Simpson, & Brown, 2003;Gossop, Marsden, Stewart, Lehmann, & Strang, 1999;Hubbard, Craddock, & Anderson, 2003;Joe, Simpson, & Broome, 1999). That is, retention is a critical issue, because dropping out from MMT can lead to relapse and further adverse consequences (Gerstein, 1994;Pettinati et al, 2008;Rabinowitz & Marjefsky, 1998;Simpson, Joe, & Rowan-Szal, 1997).…”

Demographic and clinical factors predicting retention in methadone maintenance: results from an Irish cohort

“…[12]. According to a systematic literature review of Pubmed articles, seven studies reported that methadone reduced heroin cravings, while four suggested that patients in MMT were still susceptible to heroin cravings [36]. It is possible that for some patients, methadone does not reduce heroin cravings, leading to relapse into heroin addiction.…”

An Oxycodone Conjugate Vaccine Elicits Drug-Specific Antibodies that Reduce Oxycodone Distribution to Brain and Hot-Plate Analgesia

“…Treatment options have been developed for heroin addiction, but fewer options have been studied for abuse of OXY or other prescription opioids. Agonist therapies for heroin addiction such as methadone and buprenorphine can be very effective, but their own abuse potential and risk of side effects obligate careful and frequent monitoring, and their therapeutic use is legally restricted to those regularly using substantial quantities of opioid over a sustained period of time (Fareed et al, 2011). Many prescription opioid abusers do not fit this profile because their opioid use is oral rather than intravenous and may be sporadic, yet they still run the risk of overdose, social disruption, and transition to intravenous drug use and addiction.…”