NARCOTIC WITHDRAWAL SYMPTOMS IN HEROIN USERS TREATED WITH PROPRANOLOL

Abstract

Propranolol, a β-adrenergic blocking agent, is useful in the treatment of heroin addiction. It prevents the euphoric effects of heroin; in addicts from whom heroin is withdrawn it eliminates, or much reduces, the distressing and enduring residual craving for the narcotic; and it is a non-narcotic, non-addicting, and relatively safe drug that is effective when given orally in small doses. Propranolol taken in the usual amounts does not help in the management of the acute physical withdrawal symptoms. Two cases are described in which heroin, self-administered after the use of propranolol, actually precipitated, without accompanying euphoric effects, major symptoms of withdrawal. In one case the symptoms occurred after a single oral dose of propranolol 10 mg. given for the first time in the course of a double-blind trial of this medication, and persisted for twenty-four hours despite further use of heroin. In the other case, they were subsequently reactivated for twenty-four hours by further medications with propranolol; the adverse reaction led to a request for continued treatment with propranolol as a prophylactic against recurrent use of heroin.