Pubdate: Fri, 30 Sep 2005 Source: Medical Post (Canada) Copyright: 2005 The Medical Post Contact: http://www.medicalpost.com/ Details: http://www.mapinc.org/media/3180 Author: Patricia Nicholson Bookmark: http://www.mapinc.org/heroin.htm (Heroin) Bookmark: http://www.mapinc.org/rehab.htm (Treatment) RAPID HEROIN DETOX NOT WORTH RISK, COST New York -- There's no quick fix for heroin addiction. Rapid heroin detoxification under general anesthesia does not offer enough benefit to justify the risk and expense, found a study published in the Journal of the American Medical Association. Under this treatment, an opioid antagonist drug is administered to an unconscious patient, enabling higher doses of the antagonist than could otherwise be tolerated. However, the procedure costs up to $15,000 US and has been linked to life-threatening adverse reactions, including pulmonary edema and psychosis. In the JAMA study, Dr. Eric Collins of Columbia University in New York randomized 106 heroin-dependent patients to one of three groups. In the first group, 35 patients were assigned to receive anesthesia-assisted opioid detoxification and rapid naltrexone induction. Another 37 patients were assigned to receive buprenorphine-assisted rapid opioid detoxification with naltrexone induction. In the third group, 34 patients were assigned to receive clonidine-assisted opioid detoxification with delayed naltrexone induction. All participants received withdrawal treatment as inpatients (72 hours), followed by 12 weeks of outpatient naltrexone therapy and psychotherapy. Severity of withdrawal symptoms was comparable in all three groups. There was no significant difference in rates of completion for the inpatient detoxification, or in dropout rates during the 12-week followup. There were three potentially life-threatening adverse events in the anesthesia group. The researchers concluded that anesthesia-assisted rapid detoxification is not currently a suitable treatment option. - --- MAP posted-by: Elizabeth Wehrman