Slow-release oral morphine for opioid maintenance treatment: A systematic review

British Journal of Clinical Pharmacology

Volumn 71, Issue 6, 2011, Pages 832-843

  Jegu, Jeremie ^a   Gallini, Adeline ^a   Soler, Pauline ^a   Montastruc, Jean Louis ^a,b   Lapeyre Mestre, Maryse ^a,b  

^a TOULOUSE UNIVERSITY HOSPITAL   (France)

^b Faculté de Médecine Centre Hospitalo universitaire   (France)

Author keywords

Morphine; Opiate alkaloids; Opioid related disorders rehabilitation; Review; Substance related disorders; Therapeutics

Indexed keywords

METHADONE; MORPHINE; OPIATE;

ADULT; ARTICLE; CHECKLIST; CLINICAL ASSESSMENT; CLINICAL TRIAL (TOPIC); DATA ANALYSIS; DRUG EFFICACY; DRUG RELEASE; DRUG USE; HUMAN; MAINTENANCE THERAPY; MEDICAL RECORD; PRIORITY JOURNAL; QUALITY OF LIFE; RANDOMIZED CONTROLLED TRIAL (TOPIC); SLOW RELEASE FORMULATION; STANDARDIZATION; STUDY DESIGN; SYSTEMATIC REVIEW; WITHDRAWAL SYNDROME;

ADMINISTRATION, ORAL; ANALGESICS, OPIOID; DELAYED-ACTION PREPARATIONS; HUMANS; MORPHINE; OPIOID-RELATED DISORDERS; RANDOMIZED CONTROLLED TRIALS AS TOPIC; SUBSTANCE WITHDRAWAL SYNDROME; TREATMENT OUTCOME;

EID: 79955840951     PISSN: 03065251     EISSN: 13652125     Source Type: Journal    
DOI: 10.1111/j.1365-2125.2011.03923.x     Document Type: Article

References (40)

1. United Nations Office on Drugs and Crime. World Drug Report 2009. United Nations Publication, 2009. Available at
2. O'Brien CP. Overview: the treatment of drug dependence. Addiction 1994; 89: 1565-9.
3. European Monitoring Centre for Drugs and Drug Addiction. Macro-Economic Analysis of Heroin Markets in the EU and the Impact of Substitution Treatment. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2000. Available at
4. Lavignasse P, Lowenstein W, Batel P, Constant MV, Jourdain JJ, Kopp P, Reynaud-Maurupt C, Riff B, Videau B, Mucchielli A. Economic and social effects of high-dose buprenorphine substitution therapy. Six-month results. Ann Med Interne (Paris) 2002; 153: 1S20-6.
5. Gronbladh L, Ohlund LS, Gunne LM. Mortality in heroin addiction: impact of methadone treatment. Acta Psychiatr Scand 1990; 82: 223-7.
6. European Monitoring Centre for Drugs and Drug Addiction. 2009 Annual Report on the State of the Drugs Problem in Europe. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2009. Available at
7. Lobmaier P, Gossop M, Waal H, Bramness J. The pharmacological treatment of opioid addiction-a clinical perspective. Eur J Clin Pharmacol 2010; 66: 537-45.
8. European Monitoring Centre for Drugs and Drug Addiction. Year of introduction of methadone maintenance treatment, high-dosage buprenorphine treatment, heroine-assisted treatment, slow-realease morphine and Suboxone. 2009. Available at (last accessed 18 February 2011).
9. Agence Française de Sécurité SAnitaire des Produits de Santé. Commission nationale des stupéfiants et des psychotropes. Réunion du 23 avril 2009. 2009.
10. Sladek RM, Tieman J, Currow DC. Searchers be aware: limiting PubMed searches to 'humans' loses more than you think. Intern Med J 2010; 40: 88-9.
11. Altman DG, Schulz KF, Moher D, Egger M, Davidoff F, Elbourne D, Gotzsche PC, Lang T. The revised CONSORT statement for reporting randomized trials: explanation and elaboration. Ann Intern Med 2001; 134: 663-94.
12. Vandenbroucke JP, von Elm E, Altman DG, Gotzsche PC, Mulrow CD, Pocock SJ, Poole C, Schlesselman JJ, Egger M. Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): explanation and elaboration. Epidemiology 2007; 18: 805-35.
13. Liberati A, Altman DG, Tetzlaff J, Mulrow C, Gotzsche PC, Ioannidis JP, Clarke M, Devereaux PJ, Kleijnen J, Moher D. The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. Ann Intern Med 2009; 151: W65-94.
14. Kastelic A, Dubajic G, Strbad E. Slow-release oral morphine for maintenance treatment of opioid addicts intolerant to methadone or with inadequate withdrawal suppression. Addiction 2008; 103: 1837-46.
15. Winklbaur B, Jagsch R, Ebner N, Thau K, Fischer G. Quality of life in patients receiving opioid maintenance therapy. A comparative study of slow-release morphine versus methadone treatment. Eur Addict Res 2008; 14: 99-105.
16. Mitchell TB, White JM, Somogyi AA, Bochner F. Switching between methadone and morphine for maintenance treatment of opioid dependence: impact on pain sensitivity and mood status. Am J Addict 2006; 15: 311-5.
17. Giacomuzzi S, Kemmler G, Ertl M, Riemer Y. Opioid addicts at admission vs. slow-release oral morphine, methadone, and sublingual buprenorphine maintenance treatment participants. Subst Use Misuse 2006; 41: 223-44.
18. Giacomuzzi S, Haaser W, Pilsz L, Riemer Y. Driving impairment on buprenorphine and slow-release oral morphine in drug-dependent patients. Forensic Sci Int 2005; 152: 323-4.
19. Eder H, Jagsch R, Kraigher D, Primorac A, Ebner N, Fischer G. Comparative study of the effectiveness of slow-release morphine and methadone for opioid maintenance therapy. Addiction 2005; 100: 1101-9.
20. Giacomuzzi S, Ertl M, Vigl A, Riemer Y, Gunther V, Kopp M, Pilsz W, Haaser W. Driving capacity of patients treated with methadone and slow-release oral morphine. Addiction 2005; 100: 1027.
21. Mitchell TB, White JM, Somogyi AA, Bochner F. Slow-release oral morphine versus methadone: a crossover comparison of patient outcomes and acceptability as maintenance pharmacotherapies for opioid dependence. Addiction 2004; 99: 940-5.
22. Mitchell TB, White JM, Somogyi AA, Bochner F. Comparative pharmacodynamics and pharmacokinetics of methadone and slow-release oral morphine for maintenance treatment of opioid dependence. Drug Alcohol Depend 2003; 72: 85-94.
23. Kraigher D, Ortner R, Eder H, Schindler S, Fischer G. Slow-release morphine hydrochloride for maintenance therapy of opioid dependence. Wien Klin Wochenschr 2002; 114: 904-10.
24. Kraigher D, Jagsch R, Gombas W, Ortner R, Eder H, Primorac A, Fischer G. Use of slow-release oral morphine for the treatment of opioid dependence. Eur Addict Res 2005; 11: 145-51.
25. Vasilev GN, Alexieva DZ, Pavlova RZ. Safety and efficacy of oral slow release morphine for maintenance treatment in heroin addicts: a 6-month open noncomparative study. Eur Addict Res 2006; 12: 53-60.
26. Rao RV, Dhawan A, Sapra N. Opioid maintenance therapy with slow release oral morphine: experience from India. J Subst Use 2005; 10: 259-61.
27. Fischer G, Presslich O, Diamant K, Schneider C, Pezawas L, Kasper S. Oral morphine-sulfate in the treatment of opiate dependent patients. Alcoholism 1996; 32: 35-43.
28. Mattick RP, Kimber J, Breen C, Davoli M. Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Syst Rev 2008; (2): Art. No.: CD002207. DOI: 10.1002/14651858.CD002207.pub3.
29. Directorate General for Health and Consumers. Quality of treatment services in Europe - drug treatment - situation and exchange of good practice. Directorate General for Health and Consumers Report, 2008. Available at
30. Clark NC, Lintzeris N, Gijsbers A, Whelan G, Dunlop A, Ritter A, Ling Walter W. LAAM maintenance vs methadone maintenance for heroin dependence. Cochrane Database Syst Rev 2002; (2): Art. No.: CD002210. DOI: 10.1002/14651858.CD002210.
31. Johnson RE, Chutuape MA, Strain EC, Walsh SL, Stitzer ML, Bigelow GE. A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. N Engl J Med 2000; 343: 1290-7.
32. Mattick RP, Ali R, White JM, O'Brien S, Wolk S, Danz C. Buprenorphine versus methadone maintenance therapy: a randomized double-blind trial with 405 opioid-dependent patients. Addiction 2003; 98: 441-52.
33. Montastruc JL, Arnaud P, Barbier C, Berlin I, Gatignol C, Haramburu F, Lagier G, Lapeyre-Mestre M, Mallaret M, Micaleff J. Pharmacologic criteria for medical substitution in opiate dependence. Thérapie 2003; 58: 123-5.
34. Sherman JP. Managing heroin addiction with a long-acting morphine product. Med J Aust 1996; 165: 239.
35. European Monitoring Centre for Drugs and Drug Addiction. Reviewing Current Practice in Drug Substitution Treatment in the European Union. Lisbon: European Monitoring Centre for Drugs and Drug Addiction, 2000. Available at
36. Beer B, Rabl W, Libiseller K, Giacomuzzi S, Riemer Y, Pavlic M. Impact of slow-release oral morphine on drug abusing habits in Austria. Neuropsychiatry 2010; 24: 108-17.
37. ClinicalTrials.gov. Morphine Slow-release capsultes in substitution therapy. 2010. Available at (last accessed 18 February 2011).
38. Fischer G, Jagsch R, Eder H, Gombas W, Etzersdorfer P, Schmidl-Mohl K, Schatten C, Weninger M, Aschauer HN. Comparison of methadone and slow-release morphine maintenance in pregnant addicts. Addiction 1999; 94: 231-9.
39. Fischer G, Jagsch R, Eder H. Slow-release morphine was not more effective than methadone in reducing neonatal abstinence syndrome. West J Med 2000; 172: 26.
40. Madlung-Kratzer E, Spitzer B, Brosch R, Dunkel D, Haring C. A double-blind, randomized, parallel group study to compare the efficacy, safety and tolerability of slow-release oral morphine versus methadone in opioid-dependent in-patients willing to undergo detoxification. Addiction 2009; 104: 1549-57.