Craving is Related to Persisting Heroin Use among Patients in Methadone Maintenance Treatment

Objective: Methadone maintenance treatment (MMT) is recognized as an effective treatment in patients with opiate use disorder. But its effect is compromised due to the high incidence of relapse to use heroin. In this study, we intended to investigate factors related to illicit opioid use in MMT patients. Methods: In 90 MMT patients, we collected information of demographic data, opioid urine screen results, heroin and amphetamine abuse history, daily methadone dose, heroin craving visual analogue scale (VAS), Beck Anxiety Inventory score, Beck Depression Inventory II score, and Pittsburgh Sleep Quality Index (PSQI) score. We tested the difference between groups. Results: Of 90 MMT patients, 48 of them (53.3%) were found to have positive opioid urine. Variables such as age, gender, severity of anxiety and depression, sleep quality, and daily methadone dosages were not found to be significantly related to patients' positive opioid urine. A significant difference existed in the heroin craving scores between patients with positive opioid urine and those with negative opioid urine group (37.94 ± 33.98 vs. 20.07 ± 25.78, p ＜ 0.01). But patients with higher level of heroin craving were more to have illicit opioid use. Conclusion: Heroin craving was associated with persistent heroin use among our MMT patients. Further studies are needed to clarify the complex relationships between the multidimensional nature of craving and severity of heroin dependency or mental distress to develop optimal treatment strategies.