Experimentally-induced spontaneous opiate withdrawal: Relationship to cigarette craving and expired air carbon monoxide

Smoking often increases after opioid use among those addicted to both opioids and nicotine, but the relationship between smoking and experimentally induced spontaneous opioid withdrawal (OW) has not been characterized. Six inpatient opioid-dependent smokers were stabilized on morphine 15 mg SC QID. Expired air carbon monoxide levels and smoking craving were measured for each participant on ten days when spontaneous OW was experimentally induced and on ten separate days in the absence of OW. Spontaneous OW was associated with significantly reduced carbon monoxide levels and smoking craving. Interestingly, craving was only reduced for items related to the positive reinforcing effects of smoking. These preliminary results suggest that OW may be a favorable context to initiate smoking cessation treatment interventions.