Complaints of heroin-maintained patients: A survey of symptoms ascribed to diacetylmorphine

Prescribing of injectable diacetylmorphine (DAM) for heroin dependence has raised concerns about its safety. In light of various reports by heroin-maintained patients of DAM-related adverse events, and previously established unwanted effects of opioids in pain management, we undertook a survey in Fe...

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Bibliographic Details
Published in:Drug and alcohol dependence 2006-02, Vol.81 (3), p.231-239
Main Authors: Dürsteler-MacFarland, Kenneth M., Stohler, Rudolf, Moldovanyi, Andreas, Rey, Simone, Basdekis, Raphaela, Gschwend, Patrick, Eschmann, Susanne, Rehm, Jürgen
Format: Article
Language:English
Subjects:
Addictive behaviors
Adult
Adult and adolescent clinical studies
Biological and medical sciences
Cognition Disorders - chemically induced
Cognition Disorders - epidemiology
Drug addiction
Drug Prescriptions - statistics & numerical data
Female
Health Status
Heroin
Heroin - adverse effects
Heroin - therapeutic use
Heroin Dependence - drug therapy
Heroin Dependence - epidemiology
Heroin Dependence - physiopathology
Heroin maintenance treatment
Humans
Male
Medical sciences
Myoclonus - chemically induced
Myoclonus - epidemiology
Narcotics - adverse effects
Narcotics - therapeutic use
Negative symptoms
Opioid dependence
Opioids
Pain
Prescriptions
Psychology. Psychoanalysis. Psychiatry
Psychopathology. Psychiatry
Side effects
Substance-Related Disorders - epidemiology
Surveys and Questionnaires
Time Factors
Toxicology
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Summary:Prescribing of injectable diacetylmorphine (DAM) for heroin dependence has raised concerns about its safety. In light of various reports by heroin-maintained patients of DAM-related adverse events, and previously established unwanted effects of opioids in pain management, we undertook a survey in February 2001 of a random sample of 132 (127 participated) of 1061 patients prescribed DAM in Switzerland at that time. The purpose was to document the prevalence rates of a list of unintended symptoms experienced and attributed to DAM by patients. To assess symptom complaints and other data, staff administered a six-page self-report questionnaire. The patients ascribed numerous symptoms to DAM, with the best-known being the most frequently reported (e.g. skin itching, sweating, constipation). Among potentially more problematic complaints ranged irregular menses, cognitive deficits, muscle twitches, labored breathing, pains in the cardiac region, and temporary paralysis of limbs. In the absence of a control group, however, these may also be due to other factors, such as expectation, co-medication, concomitant substance use or co-morbidity. This pilot study emphasizes the necessity of rigorous assessment of the true rates, types, severity and preventability of such complications, especially given the current efforts to establish heroin maintenance as an optional treatment for heroin dependence.
ISSN:0376-8716
1879-0046
DOI:10.1016/j.drugalcdep.2005.07.004