Conditioned responses in a methadone population. A comparison of laboratory, clinic, and natural settings

The incidence of conditioned high, craving, and withdrawal in methadone-maintained patients was compared across three settings: an artificial laboratory setting, clinic extinction sessions, and in self-reports from the natural home environment. A significant proportion of methadone patients showed increased craving and withdrawal in response to drug-related stimuli, even in the artificial laboratory setting. As stimulus opportunities became more varied (clinic extinction sessions) and closer to those in the patient's own home environment, the proportion of patients experiencing subjective craving and withdrawal increased. These results are discussed in terms of the nature of, and inter-relationships among, the conditioned responses found in opiate abusers and the potential role of these responses in relapse to drug use in the abstinent patient.