The relationship of pain intensity and opioid craving with delayed methadone dose: A preliminary study of individuals with opioid use disorder

被引:1
|
作者
MacLean, R. Ross [1 ,2 ,3 ]
Spinola, Suzanne [1 ,2 ]
Pittman, Brian [2 ]
Meyerovich, Julia [1 ]
Szollosy, Sara K. [1 ]
Wolkowicz, Noah R. [1 ,2 ]
Minnix, Stacy [1 ,2 ]
Sofuoglu, Mehmet [1 ,2 ]
机构
[1] VA Connecticut Healthcare Syst, West Haven, CT USA
[2] Yale Univ, Sch Med, New Haven, CT USA
[3] VA Connecticut Healthcare Ctr, 950 Campbell Ave 116B, West Haven, CT 06516 USA
关键词
craving; methadone; opioid use disorder; pain; NEGATIVE AFFECT; DEPENDENCE; PATTERNS;
D O I
10.1111/bcp.16027
中图分类号
R9 [药学];
学科分类号
1007 ;
摘要
AimsDespite a strong theoretical link between opioid craving and pain, little is known about the temporal relationship between pain and craving and the acute experience of pain in the context of methadone treatment. Using a cross-over design, the current study evaluated the time course of pain and craving and objective experience of pain as a function of the last methadone dose.MethodsParticipants (n = 20) presented for the study in the morning and either received methadone dose as scheduled or delayed dose until the afternoon. During the 4-h study visit, participants completed a series of tasks, including repeated assessment of pain and craving at 0, +40, +70, +130, +160 and +240 min and a cold pressor test (CPT) at +15 and +220 min.ResultsSeparate mixed model results demonstrated no effect of dosing condition on craving; however, there was a significant dosing condition by time interaction (F(5,209) = 3.38, P = .006) such that pain increased over time in the delayed methadone condition but decreased in time in the scheduled methadone condition. A mixed model predicting self-reported pain revealed a three-way interaction between dosing condition, craving and time (F(5,197) = 2.39, P = .039) explained by a positive association between craving and pain at each time point (except 240 min) in delayed condition (P-range = .004-.0001). A separate mixed model on CPT data indicated a significant condition by time interaction such that pain threshold decreased in the delayed, but not scheduled, condition (F(1,57) = 4.01, P = .050).ConclusionsThese preliminary findings highlight the potential for increased risks after even a short delay in receiving a methadone dose.
引用
收藏
页码:2977 / 2984
页数:8
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