The effect of stress on craving for methadone depends on the timing of last methadone dose

Background This study examined the extent to which the timing of last methadone dose moderates the influence of a laboratory stressor on craving for methadone in a sample of methadone maintenance patients. Methods Methadone maintenance patients (N = 41) completed a computerized stress manipulation with two levels (low and high stress) on two separate days: (1) immediately following the administration of their standard daily methadone dose and (2) immediately prior to receiving their standard daily dose. The impact of stress, timing of methadone dose and their interaction were examined on self-report measures of stress and craving for methadone. Results Craving ratings varied according to the timing of last methadone dose. Immediately following methadone dose (i.e., day 1), there was no effect for stress on craving (0.12; p = 0.30). However, prior to receiving methadone dose (i.e., day 2), the high stress effect on craving was significant (1.51; p < 0.001). Discussion The present findings indicate that patients currently receiving methadone maintenance treatment may be particularly vulnerable to stress-related relapse immediately prior to daily methadone dosing.