Long-term relapse of ultra-rapid opioid detoxification.
Ultra-rapid opioid detoxification (UROD) and subsequently induction of naltrexone maintenance therapy can be regarded as a safe and effective detoxification method for use in patients with opiate addiction. Long-term efficacy, relapse time, and relapse rate of this method is not clear. The aim of this article was to assess UROD efficacy and estimate the relapse rate in the 2-year follow-up period. Opioid-addicted, self-reporting patients referred to our hospital center were enrolled. All demographic data were collected by direct interview and based on patients' official documents. Addiction information were obtained from the patients' own admission and the interviews. Patients then began the UROD process. Thereafter, patients were scheduled for follow-up visits every 3 months for a 2-year period. A total of 424 patients were enrolled in the study and entered the UROD program, of which 400 patients completed. Of the total patients, 303 (75.75%) were successful (successful group) and 97 (24.25%) relapsed (relapse group). The unemployment rate was significantly higher in the relapse group (76%) compared with those in the successful group (21%) (P = .02). No patients in the relapse group continued naltrexone maintenance at 6-month follow-up, which was significantly lower than successful group (75.8%) (P < .05). The relapse rate was 14% at the first month visit and 24% at the 6 month and thereafter. All patients who had a relapse incident discontinued use of naltrexone before relapse happened. UROD could be an effective method of detoxification in addicted patients, but case selection, sticking to the guidelines, and maintenance therapy accompanied with social support is necessary to minimize relapse and withdrawal symptoms.
a Department of Anesthesiology, Loghman Hakim Hospital , Shahid Beheshti University of Medical Sciences , Tehran , Iran.
Alireza
A
Salimi
Farhad
F
Safari
Seyed Amir
SA
Mohajerani
Morteza
M
Hashemian
Ali-Asghar
AA
Kolahi
Kamran
K
Mottaghi
D000293:Adolescent; D000328:Adult; D000768:Anesthesia, General / Q000379:methods*; D004651:Employment / Q000706:statistics & numerical data; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use*; D009292:Narcotic Antagonists / Q000627:therapeutic use*; D058850:Opiate Substitution Treatment; D009293:Opioid-Related Disorders / Q000188:drug therapy / Q000534:rehabilitation*; D011446:Prospective Studies; D012008:Recurrence; D012044:Regression Analysis; D013375:Substance Withdrawal Syndrome / Q000517:prevention & control*; D016896:Treatment Outcome; D055815:Young Adult
D009292:Narcotic Antagonists; D009271:Naltrexone
Ultra-rapid opioid detoxification; anesthesia; naltrexone; opioid addiction; relapse