Heroin anticraving medications: A systematic review

Fareed, Ayman; Vayalapalli, Sreedevi; Casarella, Jennifer; Amar, Richard; Drexler, Karen

doi:10.3109/00952990.2010.505991

Cited by 37 publications

(24 citation statements)

References 61 publications

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“…Opioid craving predicts opioid use among persons with heroin and prescription opioid use disorders (McHugh et al, 2014; Tsui et al, 2014), and treatment with methadone and buprenorphine reduces craving (Fareed et al, 2010). Pain may be associated with increased craving for opioids.…”

Section: Introductionmentioning

confidence: 99%

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Tsui

Lira

Cheng

et al. 2016

Drug and Alcohol Dependence

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Aims In a sample of patients receiving opioid agonist therapy, we evaluated whether having chronic pain was associated with a) craving for opioids and b) illicit opioid use. Methods In a cross-sectional study of adults on buprenorphine or methadone maintenance recruited from an urban medical center, we examined any craving for opioids (primary dependent variable) in the past week and recent illicit opioid use (secondary dependent variable). Illicit opioid use was defined as a positive urine drug test (UDT) for opiates and chronic pain was defined as bodily pain that had been present for at least 3 months. Multivariable logistic regression models were fit for each outcome, adjusting for age, sex, and non-white race. Additional models adjusted for depression (PHQ-9) and anxiety (STAI). Results The sample included 105 adults on methadone or buprenorphine maintenance. Mean age was 43.8 (SD±9.4) years; 48% were female and 32% non-white; 19% were on methadone. Chronic pain was present in 68% of the sample, 51% reported craving opioids in the past week, and 16% had a positive UDT. Chronic pain was associated with 3-fold higher odds of reporting craving in the past week (aOR=3.10; 95% CI: 1.28–7.50, p-value=0.01). The relative odds for having a positive UDT were not statistically significant (aOR=2.52; 95% CI: 0.64–9.90, p=0.18). Conclusion In this sample of patients treated with opioid agonist therapy, those with chronic pain had higher odds of reporting craving for opioids. Chronic pain with associated opioid craving potentially places this population at risk for relapse.

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Section: Introductionmentioning

confidence: 99%

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Tsui

Lira

Cheng

et al. 2016

Drug and Alcohol Dependence

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“…While substitution therapy programs, high-and low-threshold, have shown very positive outcomes for opioid users (Farré, Mas, Torrens, Moreno, & Cami, 2002;Fareed, Vayalapalli, Casarella, Amar, & Drexler, 2010;Marsch, 1998) an analogous option for problematic cocaine users has yet to emerge. Opioid substitution treatment (OST) has no 4 direct effect on cocaine use, which in turn has a deleterious effect on treatment outcome for opioid dependence (Sullivan et al, 2010;Williamson, Darke, Ross, & Teeson, 2006).…”

Section: Introductionmentioning

confidence: 99%

Patterns of cocaine and opioid co-use and polyroutes of administration among street-based cocaine users in Montréal, Canada

Roy¹,

Richer²,

Arruda³

et al. 2013

International Journal of Drug Policy

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Conclusion:The heterogeneity of consumption patterns supports the importance of offering an array of interventions aimed at problematic cocaine users. These should include the provision of clean injecting and smoking material, the promotion of safe sexual behaviours and the prevention of initiation to drug injection. In the absence of specific treatment, cocaine users should have access to primary health care services and addiction treatment based on innovative behavioral and pharmacological approaches.2

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“…If needed, doses can be increased up to 4 mg each week up to a daily dose as high as 32 mg; the condition of most patients stabilizes at 16 to 24 mg. At doses of less than 8 mg per day, the program may not be effective, and higher doses may be required to achieve the maximum effect. 6,10,62 The maintenance phase begins when the most appropriate dose is established. The usual minimum length of treatment is 12 months, although, as with methadone, risks of relapse and overdose increase when buprenorphine is discontinued.…”

Section: Methadone Maintenance Approachesmentioning

confidence: 99%

“…6,61,62 Initiating buprenorphine maintenance as soon as possible (e.g., while the patient is hospitalized or after an emergency department visit) can enhance efficacy. 64 Combining maintenance therapy with a cognitive behavioral approach might improve outcomes.…”

Section: Methadone Maintenance Approachesmentioning

confidence: 99%

Treatment of Opioid-Use Disorders

Benumof

2016

N Engl J Med

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Heroin anticraving medications: A systematic review

Cited by 37 publications

References 61 publications

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Chronic pain, craving, and illicit opioid use among patients receiving opioid agonist therapy

Patterns of cocaine and opioid co-use and polyroutes of administration among street-based cocaine users in Montréal, Canada

Treatment of Opioid-Use Disorders

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