24-Hour opiate detoxification and antagonist induction at home-the ‘Asturian method’: a report on 1368 procedures
| Autor: | Julio Bobes, Collin Brewer, J. SáNCHEZ Del RíO, JE Carreño, M.T. Bascarán, Chantal Alvarez, G. I. San Narciso |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Time Factors Administration Oral Aftercare Medicine (miscellaneous) Home Care Services Hospital-Based Octreotide Clonidine Naltrexone Heroin Benzodiazepines Patient Admission Detoxification Humans Medicine Drug Implants Pharmacology Heroin Dependence business.industry Opiate Withdrawal Syndrome Antagonist Opioid-Related Disorders Substance Withdrawal Syndrome Clinical trial Psychiatry and Mental health Anti-Anxiety Agents Anesthesia Female Opiate business Methadone Follow-Up Studies medicine.drug |
| Zdroj: | Addiction Biology. 7:243-250 |
| ISSN: | 1355-6215 |
| Popis: | The technique of domiciliary rapid opiate detoxification (ROD) developed in Asturias since 1994 enables patients dependent on heroin and/or methadone (or other opiates) to start antagonist maintenance with a full dose of naltrexone (50 mg) and largely recover from the acute opiate withdrawal syndrome in a few hours at home without direct medical or nursing involvement. Detailed information on 1368 procedures is presented but in Asturias, over 3000 procedures have been completed to date without any deaths or serious medical or psychiatric complications. We also describe some recent modifications to the procedure involving the use of octreotide as an antidiarrhoeal and the insertion of subcutaneous naltrexone implants to prevent early relapse. Rather than domiciliary ROD, we think the procedure is more usefully conceptualized as domiciliary rapid antagonist induction (RAI), because treatment with well-supervised naltrexone is known to be effective in reducing relapse rates. Now that controlled studies uniformly describe greatly increased rates of transfer to naltrexone maintenance treatment following RAI, compared with conventional slower withdrawal and naltrexone induction procedures, it is important that the safety, acceptability and simplicity of this 'Asturian' RAI/ROD technique become more widely known. |
| Databáze: | OpenAIRE |
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