Philadelphia attempted to expand the access to and continuity of addiction treatment by focusing on the 15% of patients who received multiple, detoxification-only (MDO) treatments each year. Clinical Case Managers at five detoxification centers encouraged MDO patients to continue care following detoxification in methadone, residential, or outpatient rehabilitation, and sustain improvements, and...

Almost 3 million Americans have abused heroin. The most effective treatment for this concerning epidemic is opioid replacement therapy. Although, from a historical perspective, acceptance of this therapy has been slow, growing evidence supports its efficacy. There are 3 approved medications for opioid maintenance therapy: methadone hydrochloride, levomethadyl acetate, and buprenorphine hydrochl...

Despite decades of experience treating heroin or prescription opioid dependence with methadone or buprenorphine--two forms of opioid substitution therapy--gaps remain between current practices and evidence-based standards in both Canada and the United States. This is largely because of regulatory constraints and pervasive suboptimal clinical practices. Fewer than 10 percent of all people depend...

In this multi-center, naturalistic study, the effectiveness of naltrexone maintenance combined with the Community Reinforcement Approach (CRA) was investigated in detoxified, opioid-dependent patients (N=272). Patients were recruited from methadone maintenance programs. With intention-to-treat analysis, 10 months of treatment yielded abstinence rates of 28% and 32% at 10 and 16 months after det...

AIM To determine whether changes in orthoptic status take place during withdrawal from heroin and/or methadone. METHOD A prospective study of patients, using a repeated measures design, attending a 5 day naltrexone compressed opiate detoxification programme. RESULTS 83 patients were seen before detoxification (mean age 27.1 (SD 4.6) years) and 69 after detoxification. The horizontal angle o...

BACKGROUND Substance abuse or drug addiction is one of the most important health issues in every society, which can lead to physical and mental problems. OBJECTIVES This study aimed to compare the efficacy of tramadol plus gabapentin versus methadone use in the treatment of opiate withdrawal. PATIENTS AND METHODS Consenting male subjects who fulfilled the DSM-4 criteria for opiate dependenc...

SUMMARY Despite record-breaking numbers of opiate related deaths in the UK 2019, pharmacological management dependence has evolved little since advent methadone 1965. Along with harm minimisation and psychosocial interventions, mainstay treatment remains opioid substitution therapy (OST) using or buprenorphine, many patients receiving OST for years. Even these treatments, users continue to face...

Актуальность. Острые отравления метадоном в сочетании с другими психоактивными веществами, частности этанолом, нередко осложняются синдромом компрессии мягких тканей и острым повреждением почек, что требует использования методов экстракорпоральной детоксикации. Цель исследования — изучение эффективности раннего применения гемодиализа ультрафильтрацией, мембранного плазмафереза озонирования кров...

BACKGROUND/AIM Relapse of opiate dependence is a common occurrence after detoxification and introduction of opiate addicts in abstinence from opiates. Clinical evaluation showed that over 90% of opiate addicts exhibit depressive manifestations during detoxification, or develop post-detoxification depression. The aim of this study was to determine differences in the frequency of relapses, severi...