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Slow-release oral morphine as a maintenance agent in opioid dependence syndrome: an exploratory study from India

Aim: Slow-release oral morphine (SROM) as agonist maintenance agent was introduced recently in India while buprenorphine is available for the past two decades. In this study, the drug use and psychosocial status of opioid-dependent patients who were maintained on buprenorphine and subsequently shifted to SROM were assessed. Design: This is an observational study. Procedure: This study was carried out in a community-based drug treatment clinic in New Delhi. Thirty-nine opioid-dependent males maintained on sublingual buprenorphine (for at least 1 month) were included in this study. Due to difficulty in buprenorphine procurement for some period, 34 patients were shifted to SROM after informed consent. Assessments were made prior to the switch-over and after 4 weeks of stabilisation on SROM. Results: All patients initiated on SROM continued to remain in the treatment during the 4-week period. The low scores on measures of opioid withdrawal symptoms, craving and high scores on quality of life observed while on buprenorphine continued even after 4 weeks of SROM treatment. Patients on SROM reported mild adverse effects. Conclusion: SROM is as effective as buprenorphine in controlling withdrawal, craving and quality of life on short-term follow-up.