Iranian Journal of Psychiatry 2017. 12(4):226-232.

Craving and drug reward: A comparison of celecoxib and ibuprofen in detoxifying opiate addicts
sara jafari, sana khajehpour, emran mohammad razzaghi, kazem heidari, mehdi soleimani, padideh ghaeli


OBJECTIVE: Craving for substance abuse is a usual and complicated problem in patients, with opioid addiction, who are in their opioid cessation process. Craving has been added as one of the diagnostic criteria of substance use disorders in DSM-5. AIM: The present trial was intended to compare effects of celecoxib versus ibuprofen in reducing pain and in decreasing the desire to use opiates in patients undergoing opiate detoxification. (n=32). PATIENTS AND METHOD: A total of 32 patients (both inpatients and outpatients), who were undergoing opiate detoxification procedure entered this 4 week study. Subjects who suffered pain due to opiate withdrawal were randomized into two groups; group one received celecoxib 200 milligrams once daily and group two received ibuprofen 400 milligrams four times per day.  Self-reported Desire for Drug Questionnaire (DDQ) was utilized at baseline and at the end of the study to evaluate changes in opiate craving. RESULTS: After 4 weeks of treatment, with either ibuprofen or celecoxib, significant improvements in pain and craving were noted in each group. However no significant difference between the two groups was observed after 4 weeks of treatment with celecoxib and ibuprofen. CONCLUSION: The study noted that both celecoxib and ibuprofen, reduce craving in patients with opiate craving after 4 weeks of treatment without any significant difference between the two groups. The results suggest further study of celecoxib and other NSAIDs in the maintenance treatment of opiate craving.


Celecoxib, Desire for Drug Questionnaire, Ibuprofen, Opioid craving, Pain.

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Niaura RS, Rohsenow DJ, Binkoff JA, Monti PM, Pedraza M, Abrams DB. Relevance of cue reactivity to understanding alcohol and smoking relapse. Journal of abnormal psychology. 1988;97(2):133.

McAuliffe WE, Gordon RA. A test of Lindesmith's theory of addiction: The frequency of euphoria among long-term addicts. American Journal of Sociology. 1974;79(4):795-840.

Marlatt GA. Cognitive factors in the relapse process. Relapse prevention. 1985:128-200.

Jellinek E, Isbell H, Lundquist G, Tiebout HM, Duchene H, Mardones J, et al. The" craving" for alcohol. A symposium by members of the WHO Expert Committees on Mental Health and Alcohol. Quarterly journal of studies on alcohol. 1955.

Poulos C, Hinson R. S.(1981). The role of Pavlovian processes in drug tolerance and dependence: Implications for treatment. Addictive Behaviors.6:205-11.

West R, SCHNEIDERS N. Craving for cigarettes. British Journal of Addiction. 1987;82(4):407-15.

Baker TB, Morse E, Sherman JE, editors. The motivation to use drugs: a psychobiological analysis of urges. Nebraska symposium on motivation; 1986: University of Nebraska Press.

Stewart J, De Wit H, Eikelboom R. Role of unconditioned and conditioned drug effects in the self-administration of opiates and stimulants. Psychological review. 1984;91(2):251.

Tiffany ST, Wray JM. The clinical significance of drug craving. Annals of the New York Academy of Sciences. 2012;1248(1):1-17.

Wikler A. Recent progress in research on the neurophysiologic basis of morphine addiction. American journal of Psychiatry. 1948;105(5):329-38.

CHILDRESS AR, McLELLAN AT, O'BRIEN CP. Abstinent opiate abusers exhibit conditioned craving, conditioned withdrawal and reductions in both through extinction. British journal of addiction. 1986;81(5):655-60.

Kozlowski LT, Wilkinson DA. Use and misuse of the concept of craving by alcohol, tobacco, and drug researchers. British journal of addiction. 1987;82(1):31-6.

Robinson TE, Berridge KC. The neural basis of drug craving: an incentive-sensitization theory of addiction. Brain research reviews. 1993;18(3):247-91.

Steinbach G, Lynch PM, Phillips RK, Wallace MH, Hawk E, Gordon GB, et al. The effect of celecoxib, a cyclooxygenase-2 inhibitor, in familial adenomatous polyposis. New England Journal of Medicine. 2000;342(26):1946-52.

Akhondzadeh S, Jafari S, Raisi F, Nasehi AA, Ghoreishi A, Salehi B, et al. Clinical trial of adjunctive celecoxib treatment in patients with major depression: a double blind and placebo controlled trial. Depression and anxiety. 2009;26(7):607-11.

Sayyah M, Boostani H, Pakseresht S, Malayeri A. A preliminary randomized double–blind clinical trial on the efficacy of celecoxib as an adjunct in the treatment of obsessive–compulsive disorder. Psychiatry research. 2011;189(3):403-6.

Association AP. Diagnostic and statistical manual of mental disorders (DSM-5®): American Psychiatric Pub; 2013.

Ekman EF, Fiechtner JJ, Levy S, Fort JG. Efficacy of celecoxib versus ibuprofen in the treatment of acute pain: a multicenter, double-blind, randomized controlled trial in acute ankle sprain. American journal of orthopedics (Belle Mead, NJ). 2002;31(8):445-51.

Frolov RV, Ignatova II, Singh S. Mechanism of K v 2.1 channel inhibition by a selective COX-2 inhibitor SC-791—modification of gating. Brain research. 2010;1359:67-74.

Franken IH, Hendriks VM, van den Brink W. Initial validation of two opiate craving questionnaires: the Obsessive Compulsive Drug Use Scale and the Desires for Drug Questionnaire. Addictive behaviors. 2002;27(5):675-85.

Azarakhsh Mokri M. Validation for Persian Versions of “Desire for Drug Questionnaire” and “Obsessive Compulsive Drug Use Scale” in Heroin Dependents. Archives of Iranian Medicine. 2016;19(9):659.

Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual analog scale for pain (vas pain), numeric rating scale for pain (nrs pain), mcgill pain questionnaire (mpq), short‐form mcgill pain questionnaire (sf‐mpq), chronic pain grade scale (cpgs), short form‐36 bodily pain scale (sf‐36 bps), and measure of intermittent and constant osteoarthritis pain (icoap). Arthritis care & research. 2011;63(S11):S240-S52.

Bressan RA, Crippa JA. The role of dopamine in reward and pleasure behaviour–review of data from preclinical research. Acta Psychiatrica Scandinavica. 2005;111(s427):14-21.

Salamone JD, Correa M. The mysterious motivational functions of mesolimbic dopamine. Neuron. 2012;76(3):470-85.

Müller CP, Homberg JR. The role of serotonin in drug use and addiction. Behavioural brain research. 2015;277:146-92.

Buisman-Pijlman FT, Sumracki NM, Gordon JJ, Hull PR, Carter CS, Tops M. Individual differences underlying susceptibility to addiction: role for the endogenous oxytocin system. Pharmacology Biochemistry and Behavior. 2014;119:22-38.

Volkow ND, Morales M. The brain on drugs: from reward to addiction. Cell. 2015;162(4):712-25.

Wise RA. The neurobiology of craving: Implications for the understanding and treatment of addiction. Journal of abnormal psychology. 1988;97(2):118.

Dembo G, Park SB, Kharasch ED. Central nervous system concentrations of cyclooxygenase-2 inhibitors in humans. The Journal of the American Society of Anesthesiologists. 2005;102(2):409-15.

Ciceri P, Zhang Y, Shaffer AF, Leahy KM, Woerner MB, Smith WG, et al. Pharmacology of celecoxib in rat brain after kainate administration. Journal of Pharmacology and Experimental Therapeutics. 2002;302(3):846-52.

Beiche F, Scheuerer S, Brune K, Geisslinger G, Goppelt-Struebe M. Up‐regulation of cyclooxygenase‐2 mRNA in the rat spinal cord following peripheral inflammation. FEBS letters. 1996;390(2):165-9.


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