General anaesthesia does not improve outcome in opioid antagonist detoxification treatment: a randomized controlled trial.
OBJECTIVE
Opioid detoxification by administering opioid-antagonists under general anaesthesia has caused considerable controversy. This study is conducted to determine whether rapid detoxification under general anaesthesia results in higher levels of opioid abstinence than rapid detoxification without anaesthesia.


METHODS
Randomized controlled open clinical trial from September 1999 to August 2001.


METHODS
Four addiction centres in collaboration with three general hospitals in the Netherlands.


METHODS
A total of 272 opioid-dependent patients whose previous attempts to abstain were unsuccessful.


METHODS
Patients received rapid detoxification with general anaesthesia (RD-GA) or without general anaesthesia (RD).


METHODS
Urine screens and an interview (EuropASI) to assess opioid abstinence; two questionnaires (SOOS, OOWS) to measure withdrawal symptoms and one to measure craving (VAS).


RESULTS
One month after the intervention 62.8% of the patients in the RD-GA group and 60.0% in the RD group were abstinent for opioids (P = 0.71). No adverse events or complications occurred during RD; however, in the RD-GA group, five adverse events necessitated admission to a general hospital. The average 1-month cost for RD was Euros 2517 versus Euros 4439 for RD-GA.


CONCLUSIONS
Rapid detoxification under general anaesthesia did not result in higher levels of opioid abstinence than rapid detoxification without anaesthesia. The cost of the former intervention was much higher.
De Jong
Cor A J
CA
Novadic-Kentron-Network for Addiction Treatment Services, Nijmegen Institute for Scientist-Practitioners in Addiction, Radboud University Nijmegen, Nijmegen, Netherlands. C.deJong@ACSW.ru.nl
Laheij
Robert J F
RJ
Krabbe
Paul F M
PF
D000328:Adult; D000768:Anesthesia, General; D005260:Female; D006801:Humans; D008297:Male; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D009293:Opioid-Related Disorders / Q000534:rehabilitation*; D011446:Prospective Studies; D055502:Secondary Prevention; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control; D016896:Treatment Outcome
D009292:Narcotic Antagonists