2005/06/14 by Salvatore Giacomuzzi, M. Ertl, Alexander Vigl +5 · 1 citation
Medicine · Neuroscience · #Pathogenesis and Treatment of Hiccups #Schizophrenia research and treatment #Neurological Disorders and Treatments
paper · pdf · doi:10.1111/j.1360-0443.2005.01148.x
openalex publication_date 2005/06/14 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/29
Nowadays, apart from methadone, another substitution medication is prescribed in Austria for opioid treatment, such as long-acting morphine (retarded or slow-release oral morphine). Slow-release oral morphine is an opioid agonist with a 12–24-hour duration of action (Kraigher et al. 2002; Mitchell et al. 2004). Although slow-release oral morphine is used in Austria for maintenance treatment of opioid dependence, quantitative descriptions of patient outcomes have yet to be reported (Kraigher et al. 2002). While there are some data available on the effects of methadone on performance of methadone maintenance clients, there is virtually no research that has examined the effects of slow-release oral morphine on driving-related skills. However, it is still unclear whether treatment with slow-release oral morphine impairs complex psychomotor functions such as driving a car. We report preliminary data of a randomized experimental study on slow-release oral morphine's effect on driving ability under steady-state conditions in drug-dependent patients, using a standardized test battery. The traffic-relevant performance dimensions of the participants were assessed after receiving synthetic opioid maintenance therapy, by a series of tests constituting the Vienna Reaction Test System (RG), Vienna Determination Test (DT), Visual Pursuit Test (LVT), Tachistoscopic Traffic Test Mannheim for Screen (TAVTMB) and Cognitrone Test (COG) (methods described elsewhere: Soyka et al. 2001). We studied 14 drug-dependent but otherwise healthy patients in stable substitution treatment with slow-release oral morphine. Mean age was 29.7 years (SD = 6.5), and mean dosage was 348.6 mg (SD = 224.6). We compared the slow-release oral morphine patients with 27 patients under methadone maintenance. Mean age of methadone patients was 29.7 (SD = 6.9) years; mean methadone dosage was 59.1 mg (SD = 31.1). No significant differences between the two treatment groups were seen regarding demographic data and dose (P > 0.05). Our results indicate a better psychomotor performance in patients under methadone, especially within the Vienna Reaction Test System (RG), the Tachistoscopic Traffic Test Mannheim for Screen (TAVTMB) and and Cognitrone Test (COG). The methadone group showed significantly better RG scores in reaction time (P = 0.004) and correct reactions (P < 0.001). Methadone patients showed also significantly more correct answers within the TAVTMB than slow-release oral morphine clients (P < 0.001). The COG revealed a significantly lower working time (P < 0.001) and time for correct reactions (P < 0.001) in patients treated with methadone. The clinical conclusions from this study are preliminary owing to the small number of patients tested. Nevertheless, the more favourable values of patients under methadone compared with slow-release oral morphine maintenance is an interesting finding that deserves future attention. The findings are also important in terms of the widespread implementation of these treatment options in Austria, given that a large proportion of pharmacotherapy clients drive. A controlled study to compare clinical effects of methadone and slow-release oral morphine on psychomotor performance and driving ability in drug-dependent patients is planned to address this topic.