EFFICACY AND SAFETY OF 2 NEW METHODS OF RAPID INTRAVENOUS DETOXIFICATION IN HEROIN-ADDICTS PREVIOUSLY TREATED WITHOUT SUCCESS

Background New methods of rapid opiate detoxification, under intraveno us sedation, can detoxify heroin-addicted patients in 24 hours. Their clinical application has been limited by the lack of studies establish ing both efficacy and safety. Method In a randomised, controlled study , 300 treatment-refractory, heroin-addicted patients received rapid in travenous detoxification treatment (naloxone infusion, 0.06-0.08 mg/kg , then oral naltrexone 50 mg/day) under either monitored light intrave nous sedation or unmonitored deep intravenous sedation. Results All pa tients were successfully detoxified and 93% remained abstinent one mon th later. Severity of withdrawal, according to the Wang Scale modified by Loimer, was 4.9 (s.d. 3.0) points in the light sedation group and 4.8 (s.d. 2.9) in the deep sedation group (P = 0.26). Two patients (1. 3%) in the light sedation group and four (2.6%) in the deep sedation g roup required tracheal intubation (P = 0.31). There was only one sever e complication, a case of nosocomial aspirative pneumonia which improv ed with antibiotic treatment. Conclusions Successful rapid intravenous detoxification can be achieved using relatively light levels of sedat ion.