Comparing Methadone and Tincture of Opium for the Management of Opioid Withdrawal among Subjects with an Opioid Use Disorder

Introduction: Drug addiction is associated with complications such as mortality, monetary burden, and various socioeconomic problems at the individual to the community level. Methadone and Tincture of Opium (TOP) are the most commonly used drugs to help addicts maintain their drug withdrawal process and eventually permanent withdrawal. Desirable clinical experiences have been reported in the use of these two agents in the management of opioid withdrawal. The purpose of this study was to compare the efficacy of methadone and TOP using Khomree method for detoxification of drug abuse.

Materials and Methods: This study was a randomized double-blind clinical trial among opium addicts (at least one year of use) referred to Arak University of Medical Sciences. Seventy subjects were enrolled in the study according to inclusion and exclusion criteria and then randomly divided into two groups (n = 35, treated with methadone) and group 2 (n = 35, treated with TOP). Furthermore, patients were evaluated for withdrawal symptoms on days 1, 3, 7, 14 and 28 after treatment. Finally, the results were analyzed using SPSS 18 software.

Results: Severity of sweating (group 1: P = 0.0001, group 2: P =0. 005), runny nose (P = 0.001), lacrimation (P = 0.001), chord reflex (P = 001.0), fecal excretion (group 1: P = 0.001, group 2: P = 0.01, muscle twitches (P = 0.001), drooling (P = 0.001) warming sensation (P = 0.0001) and substance seeking (group 1: P = 0.0001, P = 0.008) in both groups were significantly improved during 28 days of treatment.

Conclusion: Methadone and TOP detoxification are both effective in opioid withdrawal syndrome and the effect of methadone and TOP in opiate withdrawal are not preferable. However, further studies are recommended.