Drug and Alcohol Dependence
Volume 81, Issue 2 , Pages 109-116 , 1 February 2006

Opioid antagonist detoxification under anaesthesia versus traditional clonidine detoxification combined with an additional week of psychosocial support: A randomised clinical trial

  • B. Favrat

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland
    • Corresponding Author InformationCorresponding author. Tel.: +41 21 314 4906; fax: +41 21 784 2555.
    • ,
  • G. Zimmermann

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland
    • ,
  • D. Zullino

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland
    • ,
  • S. Krenz

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland
    • ,
  • F. Dorogy

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland
    • ,
  • J. Muller

      Affiliations

    • Department of Anaesthesiology and Intensive Care Medicine, Hospital ResHO of St-Loup, Switzerland
    • ,
  • A. Zwahlen

      Affiliations

    • Department of Internal Medicine, Hospital ResHO of St-Loup, Switzerland
    • ,
  • B. Broers

      Affiliations

    • Department of Community Medicine, University Hospital, Geneva
    • ,
  • J. Besson

      Affiliations

    • Substance Abuse Division, Department of Psychiatry, University of Lausanne, Medical Outpatient Clinic, Bugnon 44, 1011 Lausanne, Vaud, Switzerland

Received 4 February 2005 ,Revised 7 June 2005 ,Accepted 9 June 2005.

Reference 

  1. Albanese AP, Gevirtz C, Oppenheim B, Field JM, Abels I, Eustace JC. Outcome and six month follow up of patients after Ultra Rapid Opiate Detoxification (UROD). J. Addict. Dis. 2000;19:11–28
  2. American Society of Addiction Medicine, 2004. Public policy statement on opioid antagonist agent detoxification under sedation or anesthesia (OADUSA). J. Addict. Dis. 19, 109–112.
  3. Badenoch J. A death following ultra-rapid opiate detoxification: the General Medical Council adjudicates on a commercialized detoxification. Addiction. 2002;97:475–477
  4. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch. Gen. Psychiatry. 1961;4:561–571
  5. Bell, J., Kimber, J., Lintzeris, N., 2001. Guidelines for rapid detoxification from opioids. NSW Health, Circular no. 2001/17, File no. 00/1287, issued on: 23 February 2001 (http://www.health.nsw.gov.au/public-health/dpb/publications/pdf/rapiddetoxification_cir2001-17.pdf).
  6. Bertschy G, Bryois C, Bondolfi G, Velardi A, Budry P, Dascal D, et al. The association carbamazepine–mianserin in opiate withdrawal: a double blind pilot study versus clonidine. Pharmacol. Res. 1997;35:451–456
  7. Bochud TC, Favrat B, Monnat M, Daeppen JB, Schnyder C, Bertschy G, et al. Ultra-rapid opiate detoxification using deep sedation and prior oral buprenorphine preparation: long-term results. Drug Alcohol Depend. 2003;69:283–288
  8. Bovill JG. Opioid detoxification under anaesthesia. Eur. J. Anaesthesiol. 2000;17:657–661
  9. Chan KBY, Man-Son-Hing M, Molnar FJ, Laupacis A. How well is the clinical importance of study results reported? An assessment of randomized controlled trials. CMAJ. 2001;165:1197–1202
  10. Cucchia AT, Monnat M, Spagnoli J, Ferrero F, Bertschy G. Ultra-rapid opiate detoxification using deep sedation with oral midazolam: short and long-term results. Drug Alcohol Depend. 1998;52:243–250
  11. Derogatis LR, Cleary PA. Factorial invariance across gender for the primary symptom dimensions of the SCL-90. Br. J. Soc. Clin. Psychol. 1977;16:347–356
  12. Dyer C. Addict died after rapid opiate detoxification. BMJ. 1998;316:170
  13. Dyer O. Doctor struck off after patient dies from detoxification. BMJ. 2001;323:955
  14. Gossop M, Green L, Phillips G, Bradley B. Lapse, relapse and survival among opiate addicts after treatment. A prospective follow-up study. Br. J. Psychiatry. 1989;154:348–353
  15. Hamilton RJ, Olmedo RE, Shah S, Hung OL, Howland MA, Perrone J, et al. Complications of ultrarapid opioid detoxification with subcutaneous naltrexone pellets. Acad. Emerg. Med. 2002;9:63–68
  16. Kleber HD. Ultrarapid opiate detoxification. Addiction. 1998;93:1629–1633
  17. Krenz, S., Dieckmann, S., Favrat, B., Spagnoli, J., Leutwyler, J., Schnyder, C., Daeppen, J.B., Besson, J., 2004. French version of the addiction severity index, 5th ed. Validity and reliability among Swiss opiate-dependent patients. French validation of the Addiction Severity Index. Eur. Addict. Res. 10, 173–179.
  18. Mayor S. Specialists criticise treatment for heroin addiction. BMJ. 1997;314:1365
  19. McGregor C, Ali R, White JM, Thomas P, Gowing L. A comparison of antagonist-precipitated withdrawal under anesthesia to standard inpatient withdrawal as a precursor to maintenance naltrexone treatment in heroin users: outcomes at 6 and 12 months. Drug Alcohol Depend. 2002;68:5–14
  20. McLellan AT, Luborsky L, Cacciola J, Griffith J, Evans F, Barr HL, et al. New data from the Addiction Severity Index. Reliability and validity in three centers. J. Nerv. Ment. Dis. 1985;173:412–423
  21. O’Connor PG, Kosten T. Rapid and ultrarapid opioid detoxification techniques. JAMA. 1998;279:229–234
  22. Perneger TV, Leplege A, Etter JF, Rougemont A. Validation of a French-language version of the MOS 36-Item Short Form Health Survey (SF-36) in young healthy adults. J. Clin. Epidemiol. 1995;48:1051–1060
  23. Pfab R, Hirtl C, Zilker T. Opiate detoxification under anesthesia: no apparent benefit but suppression of thyroid hormones and risk of pulmonary and renal failure. J. Toxicol. Clin. Toxicol. 1999;37:43–50
  24. Rabinowitz J, Cohen H, Atias S. Outcomes of naltrexone maintenance following ultra rapid opiate detoxification versus intensive inpatient detoxification. Am. J. Addict. 2002;11:52–56
  25. Rabinowitz J, Cohen H, Kotler M. Outcomes of ultrarapid opiate detoxification combined with naltrexone maintenance and counseling. Psychiatr. Serv. 1998;49:831–833
  26. Seivewright N, Greenwood J. What is important in drug misuse treatment. Lancet. 1996;347:373–376
  27. Seoane A, Carrasco G, Cabre L, Puiggros A, Hernandez E, Alvarez M, et al. Efficacy and safety of two new methods of rapid intravenous detoxification in heroin addicts previously treated without success. Br. J. Psychiatry. 1997;171:340–345
  28. Shreeram SS, McDonald T, Dennison S. Psychosis after ultrarapid opiate detoxification. Am. J. Psychiatry. 2001;158:970
  29. Singh J, Basu D. Ultra-rapid opioid detoxification: current status and controversies. J. Postgrad. Med. 2004;50:227–232
  30. Stephenson J. Experts debate merits of 1-day opiate detoxification under anesthesia. JAMA. 1997;277:363–364
  31. Strang J, Bearn J, Gossop M. Opiate detoxification under anesthesia. BMJ. 1997;315:1249–1250
  32. Streel E, Verbanck P. Ultra-rapid opiate detoxification: from clinical applications to basic science. Addict. Biol. 2003;8:141–146
  33. Ware JE, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med. Care. 1992;30:473–483
  34. Wodak A. Managing illicit drug use: a practical guide. Drugs. 1994;47:446–457

PII: S0376-8716(05)00193-6

doi: 10.1016/j.drugalcdep.2005.06.003

Drug and Alcohol Dependence
Volume 81, Issue 2 , Pages 109-116 , 1 February 2006

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