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The relationship of pain intensity and opioid craving with delayed methadone dose: A preliminary study of individuals
R Ross MacLean1,2, Suzanne Spinola1,2, Brian Pittman2
1VA Connecticut Healthcare System, West Haven, Connecticut, USA.
British Journal of Clinical Pharmacology
|March 5, 2024
Summary
Delaying methadone doses increases pain and craving in patients undergoing opioid treatment. Even short delays in methadone administration can heighten pain sensitivity and opioid craving.
Area of Science:
- Addiction Medicine
- Pain Management
- Pharmacology
Background:
- Opioid craving and pain are theoretically linked, but their temporal relationship during methadone treatment is not well understood.
- The acute experience of pain in relation to methadone dosing schedules requires further investigation.
Purpose of the Study:
- To evaluate the time course of pain and opioid craving in patients receiving methadone.
- To assess the impact of methadone dose timing on the acute experience of pain.
Main Methods:
- A cross-over study design was employed with 20 participants.
- Participants received their methadone dose either on schedule or delayed.
- Pain, craving, and pain threshold (via cold pressor test) were assessed repeatedly over 240 minutes.
Main Results:
- Pain significantly increased over time in the delayed methadone group, while it decreased in the scheduled group.
- A positive association between craving and pain was observed in the delayed methadone condition.
- Pain threshold decreased in the delayed methadone group, indicating increased pain sensitivity.
Conclusions:
- Even short delays in methadone administration may increase risks for patients.
- Findings suggest a potential for heightened pain and craving with delayed methadone dosing.
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