Dexamfetamine met vertraagde afgifte als behandeling van crackafhankelijkheid bij opiaatverslaafden die heroïne op medisch voorschrift ontvangen

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• 作者：Mascha Nuijten ; Peter Blanken ; Ben van de Wetering ; Bastiaan Nuijen…
• 刊名：Verslaving
• 出版年：2016
• 出版时间：September 2016
• 年：2016
• 卷：12
• 期：3
• 页码：207-216
• 全文大小：275 KB
• 刊物主题：Medicine/Public Health, general;
• 出版者：Bohn Stafleu van Loghum
• ISSN：1875-7073
• 卷排序：12

文摘

Heroin-assisted treatment (HAT) is effective for methadone treatment-refractory heroin dependent patients, but continued comorbid cocaine dependence remains problematic. In this randomized, double-blind, placebo-controlled trial, the authors investigated the acceptance, efficacy and safety of 60 mg sustained-release (SR) dexamfetamine as an agonist treatment for crack-cocaine and heroin dependent patients in HAT. On a daily basis, patients received either 60 mg dexamfetamine SR or identical placebo, parallel to their HAT. A total of 111 patients from four HAT-units were assessed for eligibility, of whom 73 were enrolled: 38 to the SR dexamfetamine group and 35 to the placebo group. SR dexamfetamine significantly reduced cocaine use days, and on days patients did use cocaine, the amount of cocaine administration moments significantly reduced, compared with placebo. Adverse events were generally mild and transient. The authors conclude that SR dexamfetamine is a well-accepted, effective and safe agonist pharmacotherapy for comorbid treatment-refractory cocaine dependent patients in HAT. Future research should aim to replicate these findings in chronic cocaine or other stimulant dependent patients in more routine treatment settings.