Ambulatory opiate detoxification and primary care: a role for the primary care physician.
To determine the feasibility of primary care-based ambulatory opiate detoxification (AOD) and an optimal regimen, the authors conducted a pilot study of AOD in a medical clinic comparing two regimens: clonidine and clonidine plus naltrexone. Sixty-two opiate addicts who had been referred for AOD had the following features: mean age was 34 years, 75% were male, 74% used cocaine, and 64% shared needles. Initially, 40 patients selected clonidine, 22 clonidine/naltrexone. The groups (clonidine and clonidine/naltrexone) were similar in baseline features, including: craving scores (44/100 vs. 42/100) and withdrawal scores (20/72 vs. 17/72). Overall, 61% (38/62) of initial AODs were successful, including 43% (17/40) of those using clonidine and 95% (21/22) of those using clonidine/naltrexone (p less than 0.0001). Of 45 patients who ultimately completed AOD, 78% (35/45) remained in treatment for at least one month.
O'Connor
P G
PG
Department of Medicine, Yale University School of Medicine, New Haven, Connecticut 06510.
Waugh
M E
ME
Schottenfeld
R S
RS
Diakogiannis
I A
IA
Rounsaville
B J
BJ
D000328:Adult; D003000:Clonidine / Q000627:therapeutic use*; D004359:Drug Therapy, Combination; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008658:Inactivation, Metabolic; D008297:Male; D009271:Naltrexone / Q000627:therapeutic use*; D009294:Narcotics / Q000009:adverse effects / Q000493:pharmacokinetics; D009293:Opioid-Related Disorders / Q000188:drug therapy* / Q000378:metabolism; D010819:Physician's Role; D010865:Pilot Projects; D011320:Primary Health Care; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy; D016896:Treatment Outcome
D009294:Narcotics; D009271:Naltrexone; D003000:Clonidine