TY - JOUR
T1 - Characterizing the subjective, observer-rated, and physiological effects of hydromorphone relative to heroin in a human laboratory study
AU - Dunn, Kelly E.
AU - Brands, Bruna
AU - Marsh, David C.
AU - Bigelow, George E.
N1 - Funding Information:
Fig. 4 Mean peak VAS rating of BDrug Effect^ for both intravenous (left) and subcutaneous (right) preparations, collapsed across time points. Circles represent hydromorphone, squares represent heroin. Y-axis represents mean peak rating, X-axis presents dose in mg and error bars present + standard error of the mean. Relative potency (RP) values and 95% confidence intervals are shown Funding information The study procedures were funded by the Open Society Institute and the Abell Foundation, and the manuscript preparation was funded in the form of salary support from the National Institute on Drug Abuse (NIDA) R01DA03546 (Dunn).
Publisher Copyright:
© 2017, Springer-Verlag GmbH Germany, part of Springer Nature.
PY - 2018/4/1
Y1 - 2018/4/1
N2 - Background: This study compared the effects of the several doses of the opioid agonists heroin and hydromorphone across two routes of administration in humans. The goal was to guide development of human laboratory studies of opioid effects and inform subsequent injection pharmacotherapy trials of hydromorphone-assisted treatment. Methods: A within-subject (N = 16), double-blind, double-dummy, placebo-controlled, evaluation of acute doses of heroin and hydromorphone was completed at four dose levels (placebo, low, medium, high) across two routes of administration (intravenous, subcutaneous) in non-physically dependent, opioid-experienced individuals. Subject and observer ratings, as well as physiological outcomes, were assessed. Results: Within each route of administration, heroin and hydromorphone produced effects that were qualitatively similar on most variables across the doses examined. All effects were dose-dependent. The drugs produced different effects on VAS ratings of “Feels Like Heroin,” a Heroin Identification Test, observer agonist ratings, and oxygen saturation levels. Drug-dependent differences emerged at the highest doses in all cases. Few significant main effects of Route were identified and their pattern was not uniform. Relative potency calculations across all subject, observer, and physiological outcomes that met analysis criteria revealed similar profiles and resulted in mean heroin:hydromorphone potencies of 3.35:1 and 2.88:1 for the intravenous and subcutaneous routes, respectively, and intravenous:subcutaneous potencies of 0.47:1 and 0.49:1 for heroin and hydromorphone, respectively. Conclusions: Hydromorphone produced similar subjective and physiological effects as heroin, but was more potent than heroin. The current findings support the use of hydromorphone as a model for heroin in human laboratory and clinical treatment studies, and help identify appropriate hydromorphone dose conversion ratios to produce effects qualitatively similar to heroin.
AB - Background: This study compared the effects of the several doses of the opioid agonists heroin and hydromorphone across two routes of administration in humans. The goal was to guide development of human laboratory studies of opioid effects and inform subsequent injection pharmacotherapy trials of hydromorphone-assisted treatment. Methods: A within-subject (N = 16), double-blind, double-dummy, placebo-controlled, evaluation of acute doses of heroin and hydromorphone was completed at four dose levels (placebo, low, medium, high) across two routes of administration (intravenous, subcutaneous) in non-physically dependent, opioid-experienced individuals. Subject and observer ratings, as well as physiological outcomes, were assessed. Results: Within each route of administration, heroin and hydromorphone produced effects that were qualitatively similar on most variables across the doses examined. All effects were dose-dependent. The drugs produced different effects on VAS ratings of “Feels Like Heroin,” a Heroin Identification Test, observer agonist ratings, and oxygen saturation levels. Drug-dependent differences emerged at the highest doses in all cases. Few significant main effects of Route were identified and their pattern was not uniform. Relative potency calculations across all subject, observer, and physiological outcomes that met analysis criteria revealed similar profiles and resulted in mean heroin:hydromorphone potencies of 3.35:1 and 2.88:1 for the intravenous and subcutaneous routes, respectively, and intravenous:subcutaneous potencies of 0.47:1 and 0.49:1 for heroin and hydromorphone, respectively. Conclusions: Hydromorphone produced similar subjective and physiological effects as heroin, but was more potent than heroin. The current findings support the use of hydromorphone as a model for heroin in human laboratory and clinical treatment studies, and help identify appropriate hydromorphone dose conversion ratios to produce effects qualitatively similar to heroin.
KW - Heroin
KW - Heroin-assisted treatment
KW - Hydromorphone
KW - Opioid
KW - Potency
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U2 - 10.1007/s00213-017-4814-3
DO - 10.1007/s00213-017-4814-3
M3 - Article
C2 - 29270641
AN - SCOPUS:85038631303
SN - 0033-3158
VL - 235
SP - 971
EP - 981
JO - Psychopharmacology
JF - Psychopharmacology
IS - 4
ER -