BMJ Case Reports 2017; doi:10.1136/bcr-2017-220815
  • Novel treatment (new drug/intervention; established drug/procedure in new situation)

Traditional Chinese medicine-facilitated treatments may relieve anxiety symptoms during drug switching from methadone to buprenorphine/naloxone for treating opioid dependence

Open Access
  1. Chung-Hua Hsu1,2
  1. 1Department of Chinese Medicine, Taipei City Hospital, Linsen, Chinese Medicine, and Kunming Branch, Taipei, Taiwan
  2. 2Institute of Traditional Medicine, National Yang-Ming University, Taipei, Taiwan
  3. 3Department of Psychiatry, Taipei City Hospital, Linsen, Chinese Medicine, and Kunming Branch, Taipei, Taiwan
  1. Correspondence to Professor Chung-Hua Hsu, dap63{at}
  1. K-CY and H-TW contributed equally.

  • Accepted 17 October 2017
  • Published 9 November 2017


This study investigated a 51-year-old married man with a history of heroin dependence who underwent methadone maintenance treatment for 7 years. He received traditional Chinese medicine (TCM)-facilitated treatments and switched from methadone to buprenorphine/naloxone. Strong anxiety symptoms were observed during the initial stage; therefore, we prescribed a combination of Chaihu-Shugan-San, Zhi Bai Di Huang and Chin-Gin-Kuan-Ming decoction as the major herbal synergic regimen to relieve the symptoms of opioid withdrawal, anxiety and insomnia. During the treatment course, no precipitating withdrawal syndromes were noted, and the subject was gradually relieved of his anxiety symptoms through continual TCM treatments. In conclusion, TCM is effective in facilitating the switch from methadone to buprenorphine/naloxone and relieving anxiety symptoms. Therefore, focus on TCM-facilitated treatments for heroin dependence should be increased.


  • Contributors KCY took care of the whole TCM procedure of treating the patient, and accepted the advice on paper direction from CHH for writing the paper. HTW took care of the whole methadone medicine treatment of the patient, and gave the information of methadone dosage. YHY offered support and affirmation to the patient. CHH gave great advice on drafting the structure of the paper, and the direction of treatment.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:

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