Opiate detoxification under anesthesia: No apparent benefit but suppression of thyroid hormones and risk of pulmonary and renal failure

Introduction: The new technique for opiate detoxification using anesthesia and high, repetitive doses of opiate-antagonists claims to detoxify addicts without withdrawal symptoms within 24-48 hours. We studied the method with 12 opiate addicts (5 L-polamidone, 4 dihydrocodeine, 3 heroin), using gene ral anesthesia and the antagonists naloxone 0.5 mg/kg and naltrexone > 150 mg. Objective and subjective withdrawal symptoms were measured until urine was free of drugs and patients had no withdrawal symptoms. Thyroid hormones were measured before, during, and after the anesthesia period. Results: Al l patients had moderate to severe opiate withdrawal symptoms. No detoxifica tion was finished within 48 hours. The dihydrocodeine subjects were compare d with conventionally detoxified controls; no difference was seen. The meth od suppressed thyroid hormones TT3, TT4, and TSH. The study was terminated because of side effects: 1 pulmonary failure and 2 renal failures. All pati ents survived without sequelae, Conclusion: There is no obvious benefit fro m this method, whereas the risks are high.