Document Detail

Heroin anticraving medications: a systematic review.
MedLine Citation:
PMID:  20955107     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Heroin craving is a trigger for relapse and dropping out of treatment. Methadone has been the standard medication for the management of heroin craving.
OBJECTIVES: We explored the medication options other than methadone which may have heroin anticraving properties.
METHODS: To be selected for the review, articles had to include outcome measures of the effect of the studied medication on subjective and/or objective opiate craving and be of the following two types: (1) randomized, controlled, and/or double-blind clinical trials (RCTs) examining the relationship between the studied medication and heroin craving; (2) nonrandomized and observational studies (NRSs) examining the relationship between the studied medication and heroin craving. Thirty-three articles were initially included in the review. Twenty-one were excluded because they did not meet the inclusion criteria. We present the results of 12 articles that met all the inclusion criteria.
RESULTS: Some new medications have been under investigation and seem promising for the treatment of opiate craving. Buprenorphine is the second most studied medication after methadone for its effect on opiate craving. At doses above 8 mg daily, it seems very promising and practical for managing opiate craving in patients receiving long-term opioid maintenance treatment.
CONCLUSIONS AND SCIENTIFIC SIGNIFICANCE: In doses higher than 8 mg daily, buprenorphine is an appropriate treatment for opiate craving. More research with rigorous methodology is needed to study the effect of buprenorphine on heroin craving. Also more studies are needed to directly compare buprenorphine and methadone with regard to their effects on heroin craving.
Ayman Fareed; Sreedevi Vayalapalli; Jennifer Casarella; Richard Amar; Karen Drexler
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Publication Detail:
Type:  Journal Article; Review     Date:  2010-10-19
Journal Detail:
Title:  The American journal of drug and alcohol abuse     Volume:  36     ISSN:  1097-9891     ISO Abbreviation:  Am J Drug Alcohol Abuse     Publication Date:  2010 Nov 
Date Detail:
Created Date:  2010-11-09     Completed Date:  2011-03-02     Revised Date:  2014-07-30    
Medline Journal Info:
Nlm Unique ID:  7502510     Medline TA:  Am J Drug Alcohol Abuse     Country:  England    
Other Details:
Languages:  eng     Pagination:  332-41     Citation Subset:  IM    
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MeSH Terms
Buprenorphine / therapeutic use*
Heroin Dependence / drug therapy*
Methadone / therapeutic use
Naltrexone / therapeutic use
Narcotic Antagonists / therapeutic use
Narcotics / therapeutic use*
Opiate Substitution Treatment*
Opioid-Related Disorders / drug therapy*,  rehabilitation
Randomized Controlled Trials as Topic
Substance Withdrawal Syndrome / drug therapy*,  rehabilitation
Reg. No./Substance:
0/Narcotic Antagonists; 0/Narcotics; 40D3SCR4GZ/Buprenorphine; 5S6W795CQM/Naltrexone; 70D95007SX/Heroin; UC6VBE7V1Z/Methadone

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