Continuous naloxone administration suppresses opiate withdrawal symptoms in human opiate addicts during detoxification treatment

Loimer, Norbert; Schmid, Rainer; Presslich, O; Lenz, Kurt

doi:10.1016/0022-3956(89)90020-4

Cited by 67 publications

(24 citation statements)

References 6 publications

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“…The correct position of the catheter was documented with a chest X-ray. Opiate detoxification was performed according to a standard protocol, described previously [14]. In short, general anesthesia was induced by 500-1000 mg methohexitone (Brietal  , EliLilly Austria) and a single dose of 0.8 mg/kg pancuronium (Pavulon  , NV Organon, The Netherlands).…”

Section: Methodsmentioning

confidence: 99%

Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress

Lenz

Buder

Firlinger

et al. 2014

Wien Klin Wochenschr

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Section: Methodsmentioning

confidence: 99%

Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress

Lenz

Buder

Firlinger

et al. 2014

Wien Klin Wochenschr

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“…Sixteen physical and 13 psychological symptoms were presented. The selection of variables is based in part on previous clinical observations within our methadone programme and in part on descriptions of withdrawal states noted in the literature [20][21][22].…”

Section: Methodsmentioning

confidence: 99%

Withdrawal from Methadone Maintenance Treatment

Hiltunen¹,

Eklund²

2002

Eur Addict Res

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Although factors associated with successful termination of methadone maintenance treatment (MMT) have been well studied, the question of why certain methadone patients try to taper off methadone while others do not is still unanswered. Those patients who wish to continue MMT should of course be allowed to stay in treatment. However, even if only a small portion of the MMT patients wish to quit maintenance treatment, they should be offered all possible support by the treatment staff to maximize the possibility of a successful outcome. In the present study, we compared two groups of well-functioning MMT patients with respect to background factors, methadone-related factors, drug-related factors and psychological characteristics: one group consisted of patients who were trying to terminate their MMT (group 1) and the other group consisted of patients who were not trying (group 2). Each of the groups contained 25 well-rehabilitated subjects matched by age, gender and the number of years in MMT. The results show that the patients who were not trying to terminate MMT (in comparison to group 1) were not influenced by others to try to quit methadone, had a long history of opiate use as well as mixed drug use prior to MMT, had a higher methadone dose and reported a lower degree of anticipated abstinence symptoms. According to the statements of the subjects in group 2, the most important reason for not quitting treatment was the belief that they needed the methadone. The fact that they knew others who had failed to quit MMT and low confidence in succeeding were other common answers. Further, our results suggest that patients who were satisfied with their overall drug situation were less inclined to make a withdrawal attempt.

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“…3,4 In addition, evidence exists to support a role for naltrexone and other opioid antagonists in blunting drug craving. 5,6 Although the mechanism is not entirely clear, the speculation is that receptor occupancy by an antagonist is sufficient to blunt cravings.…”

Section: Discussionmentioning

confidence: 99%

Complications of Ultrarapid Opioid Detoxification with Subcutaneous Naltrexone Pellets

et al. 2002

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Abstract. Rapid and ultrarapid opioid detoxification (ROD and UROD) centers promise quick, painless, same-day detoxification treatment for patients with opioid addiction. The goal of ROD and UROD is to provide a rapid transition from opioid dependency to oral naltrexone therapy. The patient is given general anesthesia and high-dose opioid antagonists. This induces a severe withdrawal but spares the patient the experience. In theory, the process is complete within four to five hours. The patient awakens without opioid dependency and is started on oral naltrexone. Any subsequent, persistent withdrawal symptoms are treated symptomatically. A novel, unapproved approach is to compound a pellet of naltrexone and implant it in the subcutaneous tissue. In theory, this should result in continuous therapeutic levels for this drug, and avoid issues with noncompliance. Case series: This article reports six cases of complications from the same detoxification center that performed UROD with naltrexone pellet implantation, including pulmonary edema, prolonged withdrawal, drug toxicity, withdrawal from cross-addiction to alcohol and benzodiazepines, variceal rupture, aspiration pneumonia, and death. Conclusions: The risks of this procedure are great and further studies should assess its safety and the novel use of naltrexone. Key words: opioids; heroin; addiction; detoxification; rapid detoxification; ultrarapid detoxification; naltrexone. ACADEMIC EMERGENCY MEDICINE 2002; 9:63-68 P ATIENTS with opioid addiction often struggle to achieve detoxification. Discontinuation of opioid use results in the severe discomfort of withdrawal. Many find methadone maintenance undesirable. For these patients, rapid and ultrarapid opioid detoxification (ROD and UROD) centers promise quick, painless, same-day detoxification treatment for patients with opioid addiction. This allows rapid transition from opioid dependency to oral naltrexone therapy. General anesthesia is given via endotracheal tube as well as highdose opioid antagonists. The induced withdrawal is complete within four to five hours and the patient awakens without opioid dependency. The patient is then started on oral naltrexone and any subsequent, persistent withdrawal symptoms are treated symptomatically. A novel, unapproved approach is to compound a pellet of naltrexone and

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Continuous naloxone administration suppresses opiate withdrawal symptoms in human opiate addicts during detoxification treatment

Cited by 67 publications

References 6 publications

Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress

Effect of proton pump inhibitors on gastric pH in patients exposed to severe stress

Withdrawal from Methadone Maintenance Treatment

Complications of Ultrarapid Opioid Detoxification with Subcutaneous Naltrexone Pellets

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