Traditional Chinese Medicine-facilitated switch from methadone to buprenorphine-naloxone for treatment of heroin dependence: a case report.

The switch from methadone to buprenorphine-naloxone for individuals with heroin dependence is associated with several obstacles and challenges. Such patients may experience discomfort from discontinuing methadone, precipitated withdrawal symptoms induced by buprenorphine-naloxone, and poor psychosocial adjustments such as anticipatory anxiety regarding severe opioid withdrawal. We herein describe a 46-year-old man with a history of heroin dependence who underwent Traditional Chinese Medicine (TCM)-facilitated switching from methadone to buprenorphine-naloxone. No precipitated withdrawal was induced by buprenorphine-naloxone. The drug-switching process was successful and smooth. He maintained abstinence from heroin for the following year. In this case, we applied TCM for enhancement of methadone metabolism and detoxification, analgesic effects, and anxiolytic and hypnotic effects during the drug switch. We observed that TCM effectively facilitated the switch from methadone to buprenorphine-naloxone in our case. Further studies regarding TCM-facilitated treatment for heroin dependence should be conducted.

[1]  C. Stumpf.  Opiate , 2020, Definitions.

[2]  Han-Ting Wei,et al.  Traditional Chinese medicine-facilitated treatments may relieve anxiety symptoms during drug switching from methadone to buprenorphine/naloxone for treating opioid dependence , 2017, BMJ Case Reports.

[3]  Britt-Marie Lindgren,et al.  Experiences of Living With Opioid Dependence: An Interview Study Among Individuals Participating in Medication-Assisted Treatment , 2017, Issues in mental health nursing.

[4]  Declan T. Barry,et al.  The Availability of Ancillary Counseling in the Practices of Physicians Prescribing Buprenorphine , 2016, Journal of addiction medicine.

[5]  J. Schneider,et al.  Efficacy of Full µ-Opioid Receptor Agonists is not Impaired by Concomitant Buprenorphine or Mixed Opioid Agonists/Antagonists – Preclinical and Clinical Evidence , 2016, Drug Research.

[6]  C. Green,et al.  Methadone, buprenorphine and preferences for opioid agonist treatment: A qualitative analysis. , 2016, Drug and alcohol dependence.

[7]  K. Saulsgiver,et al.  Characterizing opioid withdrawal during double-blind buprenorphine detoxification. , 2015, Drug and alcohol dependence.

[8]  Chunfu Wu,et al.  Xiaochaihutang prevents depressive‐like behaviour in rodents by enhancing the serotonergic system , 2014, The Journal of pharmacy and pharmacology.

[9]  Cai Song,et al.  Wen-Dan Decoction Improves Negative Emotions in Sleep-Deprived Rats by Regulating Orexin-A and Leptin Expression , 2014, Evidence-based complementary and alternative medicine : eCAM.

[10]  J. Qiu,et al.  The effect of Chaihu-Shugan-San and its components on the expression of ERK5 in the hippocampus of depressed rats. , 2014, Journal of ethnopharmacology.

[11]  Li-Tzy Wu,et al.  Buprenorphine-mediated transition from opioid agonist to antagonist treatment: state of the art and new perspectives. , 2012, Current drug abuse reviews.

[12]  A. Zhang,et al.  Metabolomic study of insomnia and intervention effects of Suanzaoren decoction using ultra-performance liquid-chromatography/electrospray-ionization synapt high-definition mass spectrometry. , 2012, Journal of pharmaceutical and biomedical analysis.

[13]  Yi‐Ming Arthur Chen,et al.  Effects of education on harm-reduction programmes , 2011, The Lancet.

[14]  N. Chang,et al.  Traditional Chinese medicine, Xue-Fu-Zhu-Yu decoction, potentiates tissue plasminogen activator against thromboembolic stroke in rats. , 2011, Journal of ethnopharmacology.

[15]  W. Ling,et al.  Provision of Ancillary Medications During Buprenorphine Detoxification Does Not Improve Treatment Outcomes , 2010, Journal of addictive diseases.

[16]  Mingsheng Huang,et al.  A Study on Fu-Yuan Pellet, a Traditional Chinese Medicine Formula for Detoxification of Heroin Addictions , 2009, The American journal of drug and alcohol abuse.

[17]  Y. Bao,et al.  Methadone Maintenance Treatment of Heroin Abuse in China , 2008, The American journal of drug and alcohol abuse.

[18]  B. Li,et al.  Tai-Kang-Ning, a Chinese Herbal Medicine Formula, Alleviates Acute Heroin Withdrawal , 2008, The American journal of drug and alcohol abuse.

[19]  Jie Shi,et al.  Traditional Chinese medicine in treatment of opiate addiction , 2006, Acta Pharmacologica Sinica.

[20]  Dongqi Zhao,et al.  Opiate addiction in China: current situation and treatments. , 2006, Addiction.

[21]  M. Farrell,et al.  Drug-related mortality and fatal overdose risk: Pilot cohort study of heroin users recruited from specialist drug treatment sites in London , 2003, Journal of Urban Health.

[22]  H. Hinterhuber,et al.  Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment. , 2003, Addiction.

[23]  S. Darke,et al.  Suicide among heroin users: rates, risk factors and methods. , 2002, Addiction.

[24]  K. Kondo,et al.  Protective effects of Saiko-ka-ryukotsu-borei-to (Chai-Hu-Jia-Long-Gu-Mu-Li-Tang) against atherosclerosis in Kurosawa and Kusanagi-hypercholesterolemic (KHC) rabbits. , 2001, Pharmacological research.

[25]  J. Ramsey,et al.  Death rate from use of ecstasy or heroin , 1999, The Lancet.

[26]  K. Sporer.  Acute Heroin Overdose , 1999, Annals of Internal Medicine.

[27]  R. Ali,et al.  Buprenorphine for the management of opioid withdrawal. , 2006, The Cochrane database of systematic reviews.

[28]  A. Abrantes,et al.  A family study of the high-risk children of opioid- and alcohol-dependent parents. , 2002, The American journal on addictions.

[29]  T. Mark,et al.  The economic costs of heroin addiction in the United States. , 2001, Drug and alcohol dependence.

[30]  J. Caplehorn,et al.  Methadone maintenance and addicts' risk of fatal heroin overdose. , 1996, Substance use & misuse.