title: Evaluation of the opioid addiction test in an out-patient drug dependency unit.
abstract: BACKGROUND
  The opioid addiction test is based on the measurement of pupil dilatation in opioid-dependent people in response to conjunctivally applied naloxone hydrochloride. A positive response (pupil dilatation) indicates that the subject is dependent on opioids.
  
  
  OBJECTIVE
  To evaluate the test in an out-patient setting and to identify factors affecting its outcome.
  
  
  METHODS
  Pupil size was measured using binocular pupillometry in 100 new patients attending an out-patient clinic for assessment and treatment of opioid use. Measurement was repeated 40 minutes after the unilateral instillation of naloxone drops into the conjunctival sac.
  
  
  RESULTS
  We performed 127 tests, of which 103 (81.1%) were positive. Males, and those not on methadone at the time of the test, were more likely to have a negative test result.
  
  
  CONCLUSIONS
  The opioid addiction test proved to be a very useful tool for the rapid diagnosis of opioid dependence in the out-patient clinic. Specialist pupillometric equipment increases the number of patients correctly identified as opioid-dependent on the first visit, but is not essential.
authors.affiliation: Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London.
authors.forename: A H
authors.initials: AH
authors.lastname: Ghodse
authors.forename: J L
authors.initials: JL
authors.lastname: Greaves
authors.forename: D
authors.initials: D
authors.lastname: Lynch
mesh_terms: D000293:Adolescent; D000328:Adult; D000553:Ambulatory Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009293:Opioid-Related Disorders / Q000175:diagnosis*; D012025:Reflex, Pupillary; D015813:Substance Abuse Detection / Q000379:methods* / Q000592:standards; D013375:Substance Withdrawal Syndrome / Q000209:etiology; D016482:Urinalysis / Q000592:standards