P0101 - Opioid withdrawal symptoms: Low efficacy of non-opioid drugs

Abstract

Introduction:

Opioid withdrawal, stress or cues associated with opioid consumption can induce opioid craving. If opioids are not available, opioid dependent patients usually search for alternative drugs. Since several non-opioid drugs stimulate the endogenous opioidergic system, this concept may explain their frequent use by opioid dependent patients. We hypothesized that non-opioid drugs alleviate opioid withdrawal symptoms and are therefore consumed by opioid addicts.

Methods:

We asked 89 opioid dependent patients participating in an outpatient opioid maintenance program to estimate the potential of several non-opioid drugs in being able to alleviate opioid withdrawal.

Results:

Values (mean ± SD) for benzodiazepines: 3.2 ± 1.1, tricyclic antidepressants 3.6 ± 1.1, cannabis 3.6 ± 1.0, alcohol 4.1 ± 1.1, cocaine 4.2 ± 1.1, amphetamine 4.4 ± 0.9, nicotine 4.7 ± 0.7, caffeine 4.9 ± 0.5. A worsening of opioid withdrawal was reported by 62% of the patients for cocaine, 62% for amphetamine, 50% for caffeine, 37.5% for cannabis, 27% for nicotine, 26% for alcohol, 8% for tricyclic antidepressants and 3% for benzodiazepines.

Discussion:

Our study shows a low efficacy of non-opioid drugs in alleviating opioid withdrawal symptoms. The data basis of this study was good and the sample was suitable to be asked for estimations of drug-drug interactions. 26% - 62% of the patients even reported a worsening of opioid withdrawal for cannabis, alcohol, cocaine and amphetamine. Only benzodiazepines and tricyclic antidepressants were reported to have a moderate positive effect on opioid withdrawal.