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The effect of stress on craving for methadone depends on the timing of last methadone dose
Authors:Ilgen Mark  Jain Anuja  Kim Hyungjin Myra  Trafton Jodie A
Affiliation:a Department of Veterans Affairs, Serious Mental Illness Treatment, Research, and Evaluation Center, 2215 Fuller Road (11H), Ann Arbor, MI 48105, USA
b Department of Psychiatry, University of Michigan, Rachel Upjohn Building, 4250 Plymouth Road, Ann Arbor, MI 48109-5763, USA
c University of Michigan Medical School, 1301 Catherine Road, Ann Arbor, MI 48109, USA
d Center for Statistical Consultation and Research, University of Michigan, 915 E. Washington Street, Ann Arbor, MI 48109-1070, USA
e Department of Veterans Affairs, Palo Alto Health Care System, Center for Health Care Evaluation, 795 Willow Road (152-MPD), Menlo Park, CA 94025, USA
f Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 300 Pasteur Drive, Stanford, CA 94305, USA
Abstract:

Background

This study examined the extent to which the timing of last methadone dose moderates the influence of a laboratory stressor on craving for methadone in a sample of methadone maintenance patients.

Methods

Methadone maintenance patients (N = 41) completed a computerized stress manipulation with two levels (low and high stress) on two separate days: (1) immediately following the administration of their standard daily methadone dose and (2) immediately prior to receiving their standard daily dose. The impact of stress, timing of methadone dose and their interaction were examined on self-report measures of stress and craving for methadone.

Results

Craving ratings varied according to the timing of last methadone dose. Immediately following methadone dose (i.e., day 1), there was no effect for stress on craving (0.12; p = 0.30). However, prior to receiving methadone dose (i.e., day 2), the high stress effect on craving was significant (1.51; p < 0.001).

Discussion

The present findings indicate that patients currently receiving methadone maintenance treatment may be particularly vulnerable to stress-related relapse immediately prior to daily methadone dosing.
Keywords:Methadone   Opiate dependence   Craving   Withdrawal   Relapse
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