A Double Blind Comparative Study of Usefulness of Diphenoxylate and Propoxyphene Napsylate in the Withdrawal Treatment of Opium Addicts

At present probably the most popular and effective method to alleviate the withdrawal symptoms in narcotic addicts is the substitution of the stronger narcotics by methadone which because of its milder addictiveness can be more easily and rapidly withdrawn (Weiland and Chambers, 1970). However, methadone itself is an addictive drug, its abuse liability being enhanced by the fact that it can also be used by injection and its comparatively low cost. Further, since it is no longer available in the Indian market a search must be made for a safe and effective substitute. There are two drugs that hold promise in this regard. Fraser and Isbell (1961) studied the addiction liability of diphenoxylate, a congener of Pethidine. They concluded that its abuse liability was less than that of morphine and comparable to codeine. Subsequently, Goodman (1968) reported the use of diphenoxylate in withdrawal of twenty narcotic addicts using a total dose of 260 nig. over five and a hall days. He concluded that it resulted in allaying the usual severe symptoms of withdrawal but found it necessary to use barbiturate and phet othiazines or glutethimide to control the symptoms of anxiety in these subjects. More recently GJatt et al. (1970 J found the combination of Diphenoxylate with Heminevrin to be quite effective in the treatment of the withdrawal abstinence syndrome in a series of 88 narcotic (including 70 heroin) addicts.