Oxytocin protocol appears workable and safe for methadone patients who use cocaine

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Some 30 to 60 percent of patients in methadone maintenance therapy (MMT) for opioid use disorders use cocaine. Compared to other MMT patients, those who use cocaine have higher rates of relapse and mortality. Studies with animals have suggested that the hormone oxytocin could be doubly helpful to these patients, by reducing the addictive effects of both opioids and cocaine. Now, researchers supported by the National Institute on Drug Abuse have developed a protocol for adjunctive oxytocin treatment, and a pilot study has indicated that it is workable and safe for MMT patients.

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The researchers assigned 23 voluntary and stable MMT patients who used crack cocaine to take oxytocin or a placebo via a nasal spray. Research staff administered the first of two daily doses of medication or placebo during the patient’s morning clinic visit and gave the patients the second dose to self-administer in the afternoon. All the patients except one completed the two-week protocol, suggesting that MMT patients can and will adhere to such a regimen.

Oxytocin reduces tolerance for opioids, and this has led to concerns that exposing MMT patients to the hormone might put them at risk for potential respiratory or other side effects from methadone. The study allayed these concerns. The researchers did not observe, nor did the patients report, any side effects related to the treatment.

Although the study was too small to determine whether oxytocin is an effective treatment for this patient population, the results were promising and warrant additional and larger studies.