Time course of naloxone-precipitated withdrawal after acute methadone exposure in humans

Drug Alcohol Depend. 1991 Dec;29(1):39-46. doi: 10.1016/0376-8716(91)90020-y.

Abstract

This study examined naloxone-precipitated withdrawal symptoms from 24 to 168 h after pretreatment with a single 30-mg i.m. dose of methadone in 6 male subjects who were experienced users of opioid drugs but were not currently dependent. The study showed that acute physical dependence signs and symptoms could be reliably precipitated with a small dose of naloxone (0.75 mg/70 kg i.m.) for as long as 96 h (4 days) after a single dose of methadone. The intensity of symptoms at 24 h post-methadone was similar to that observed at 96 h; no precipitated withdrawal effects were observed at 168 h (7 days) after methadone administration. The magnitude of precipitated withdrawal effects at 96 h was not attenuated by the administration of a prior naloxone challenge at 24 h post-methadone. Agonist effects (pupillary constriction; subjective effects) were detectable at 24 h but not at 96 h post-methadone. The results suggest that methadone engenders long-lasting physical dependence effects that can be detected beyond the dissipation of acute agonist effects. Methadone pretreatments may provide a convenient mechanism for the production and examination of long-term mu-opiate receptor physical dependence.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Arousal / drug effects
  • Arousal / physiology
  • Humans
  • Injections, Intramuscular
  • Male
  • Metabolic Clearance Rate / physiology
  • Methadone* / administration & dosage
  • Methadone* / pharmacokinetics
  • Naloxone / administration & dosage*
  • Neurologic Examination
  • Opioid-Related Disorders / physiopathology
  • Opioid-Related Disorders / rehabilitation*
  • Receptors, Opioid / drug effects
  • Receptors, Opioid / physiology
  • Receptors, Opioid, mu
  • Substance Withdrawal Syndrome / physiopathology*

Substances

  • Receptors, Opioid
  • Receptors, Opioid, mu
  • Naloxone
  • Methadone