Craving patterns in methadone maintenance treatment with dextromoramide as adjuvant

A study was performed to establish the effect on opiate craving among six long-term opiate-dependent subjects in methadone maintenance treatment. Subjects currently stabilised on methadone, received 5 or 10 mg dextromoramide besides methadone. During the study the usual methadone dose was diminished according to the individual subject's expectation of the effect of dextromoramide addition. A clear drug-effect relationship between the increment of dextromoramide plasma concentration and decrement of opiate craving could be seen. A craving increase before drug administration was seen in three cases. The results could imply beneficial effects of a short-acting opiate on diminishing craving in opiate addicts who are difficult to stabilise with methadone maintenance treatment.