People who take methadone use fewer illicit opioids when galantamine is added to their therapy, research shows
The study, published in the American Journal on Addictions (4 June 2019), was a secondary analysis of trial data in which 120 methadone-maintained people with concurrent cocaine dependence were randomly assigned to galantamine or placebo for 12 weeks.
The researchers found that urine samples were negative for opioids in 76.7% of samples from the treatment group and 62.4% in the placebo group, and these effects persisted into the six-month follow-up. Self-reported days of abstinence from illicit opioids were significantly higher in the galantamine group than in the placebo group during the study period, at 92.5% compared with 86.3%.
Also, the time to first opioid use was significantly longer in the galantamine group, at a median of 52.5 days compared with 14.5 days in the placebo group.
Galantamine is a cholinesterase inhibitor used in Alzheimer’s disease to improve cognitive and emotional function, and research has suggested that it is beneficial in cigarette and alcohol addiction.
The original trial published in 2018 in the Journal of Clinical Psychology
tested whether galantamine enhanced the effect of computerised cognitive behavioural therapy in people with cocaine addiction.
“If these results are supported in future trials, galantamine may hold promise across multiple drugs of abuse, including opioids,” the researchers concluded.
 Carroll K, DeVito E, Yip S et al. Double-blind placebo-controlled trial of galantamine for methadone-maintained individuals with cocaine use disorder: secondary analysis of effects on illicit opioid use. Am J Addict 2019;28:238–245. doi: 10.1111/ajad.12904