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Heroin Addiction and Related Clinical Problems: 2010, 12, 3 (pages: 5 - 8)

Psychological performance and sedation following injectable opioid administration

Forzisi L., Mitchell T. B., Bond A., Lintzeris N., Spofforth N., Strang J.

Summary: Injectable opioid treatment (IOT) can be an effective strategy for heroin users who respond poorly to treatment with oral methadone, but its safety profile is yet to be fully characterised. This study assessed the risks of sedation and impaired psychological performance in 13 IOT patients following injection of their regular dose of heroin (n=7) or methadone (n=6). Measures of psychological performance (digit symbol substitution task, DSST; cancellation task, CT) and sedation (visual analogue scale, VAS) were taken at baseline and 15, 30 and 60 minutes post-injection. Comparisons were made between the methadone and heroin groups, with reference to data collected in control groups maintained on oral methadone or sublingual buprenorphine. Results indicated that performance and sedation did not change significantly in the hour after injection. However, patients prescribed injectable heroin or injectable methadone showed significantly worse psychological performance at the time of peak effect compared to patients prescribed oral methadone or buprenorphine. These findings suggest that further research is required to characterise possible psychological performance deficit in IOT patients.