fl.Sf,VIER SCIENCE IRELAhll Drug and Alcohol Dependence 34 (1994) 237-242 The effects of high and low doses of methadone on cigarette smoking Joy M. Schmitz *, John Grabowski, Howard Rhoades zyxwvutsrqponmlkjihgfedcbaZ Substance Abuse Reseurch Centre, Department of Psychiatry and Behuvioral Sciences. Houston TX 77030, USA University of Texas Medical School. 1300 Mour.wnd .4 w (Accepted 27 July 1993) Abstract The effect of methadone dose on the cigarette smoking of five methadone maintenance subjects was studied in a clinical setting. Following a two-week baseline period, daily doses of methadone were either increased (50-80 mg) or decreased (80-50 mg) every two weeks according to an A-B-A-B study design. Continuous self-monitoring was used to collect data on natural smoking behav- ior, and expired air carbon monoxide (CO) levels were measured at each clinic visit. The predicted methadone dose-related changes in smoking were found in three of the five subjects. Fine-grained analysis of self-monitoring records showed that the proportion of total daily smoking was highest within 4 h after taking methadone for three subjects. CO levels were not significantly associated with smoking rate. The results further support and extend previous reports that methadone may produce dose-related increases in smoking. No reactive effects of self-monitoring were observed, and compliance with this procedure was extremely high, suppor- ting the usefulness of this method for assessing natural smoking behavior in this population. Key zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPONMLKJIHGFEDCBA w or ds: Methadone maintenance; Tobacco smoking; Nicotine; Self-monitoring zyxwvutsrqponmlkjihgfedcbaZYXWVUTSRQPO 1. Intmduction Tobacco dependence is common among users of other drugs, with smoking prevalence ranging from 85% to 100% in abusers of alcohol, opioids, and cocaine (Istvan and Matarazzo, 1984; Rounsaville et al., 1985; Burling and Ziff, 1988; DiFranza and Guerrera, 1990). The observed correlation between cigarette smoking and other drug use has been extended by laboratory studies demonstrating a more direct causal relationship between these variables, Acute administration of ethanol (Grif- liths, Bigelow and Liebson, 1976; Mello et al., 1980a), heroin (Mello et al., 1980b), psychomotor stimulants (Schuster, Lucchesi and Emley, 1979; Henningfield and Griffiths, 1981), and sedatives (Henninglield, Chait and Grifliths, 1983) have produced increases in rates of ciga- rette smoking. Methadone itself has been shown to influence ciga- * Corresponding author, University of Texas Mental Sciences Insti- tute, 1300 Moursund, Houston, TX 77030, USA. rette smoking in subjects maintained on methadone. Chait and Griffiths (1984), in the only published report to date, examined the interaction of acute methadone administration and smoking in five male methadone maintenance patients. Subjects participating in this controlled laboratory study were allowed to smoke ad libitum 90 min after receiving either a placebo, dex- tromethorphan, or one of three doses of methadone (0.5, 1.0, or 2.0 times their regular maintenance dose). It was found that methadone pretreatment produced substantial increases in cigarette smoking, level of car- bon monoxide (CO), and subjective ratings of smoking satisfaction. This study represents the first attempt to use a non- laboratory methodology to explore further the relation- ship between methadone administration and cigarette smoking. Five methadone maintenance patients record- ed their daily smoking over an 8-week study period involving systematic methadone dose manipulations implemented under double blind conditions. The pri- mary objectives were (a) to replicate the findings from laboratory studies in showing a dose-dependent rela- 0376-8716/94/$07.00 0 1994 Elsevier Science Ireland Ltd. All rights reserved SSDI 0376-8716(93)0953-Y