Opioid-induced constipation reversal in response to placebo in a patient with a history of IBS receiving methadone maintenance therapy

BMJ Case Rep. 2015 Nov 13:2015:bcr2015211954. doi: 10.1136/bcr-2015-211954.


Opioid-induced constipation (OIC) is one of the major side effects in patients receiving methadone maintenance treatment (MMT). Quite often, constipation becomes a factor significantly affecting therapeutic options and choices. Currently used approaches are symptomatic and in many cases ineffective. At the same time, it is well known that the gastrointestinal system is a subject for psychosomatic influences. In this case report, we describe an unexpected outcome of placebo administration in a patient suffering from OIC since her participation in MMT. The patient participated in a triple-blind randomised placebo-controlled trial of naloxone for treatment of OIC. As part of the study crossover design, the patient received 1 week of placebo followed by 1 week of naloxone, and had significant improvement in her bowel functioning when receiving placebo, then returned to baseline during the second week of the study.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Analgesics, Opioid / administration & dosage
  • Analgesics, Opioid / adverse effects*
  • Constipation / chemically induced*
  • Constipation / drug therapy
  • Cross-Over Studies
  • Female
  • Humans
  • Irritable Bowel Syndrome / complications*
  • Irritable Bowel Syndrome / drug therapy
  • Laxatives / administration & dosage
  • Methadone / administration & dosage
  • Methadone / adverse effects*
  • Middle Aged
  • Naloxone / administration & dosage
  • Naloxone / adverse effects*
  • Narcotic Antagonists / administration & dosage
  • Narcotic Antagonists / adverse effects*
  • Narcotics / administration & dosage
  • Narcotics / adverse effects*
  • Opiate Substitution Treatment / adverse effects*
  • Patient Satisfaction
  • Quality of Life
  • Randomized Controlled Trials as Topic
  • Treatment Outcome


  • Analgesics, Opioid
  • Laxatives
  • Narcotic Antagonists
  • Narcotics
  • Naloxone
  • Methadone