Six-month follow-up study of ultrarapid opiate detoxification with naltrexone.
BACKGROUND
Illicit opiate use has an increasing incidence and prevalence, which increases mortality and morbidity, marginalization, and criminal behaviors, and causes major adverse effects on society.


OBJECTIVE
This study aimed to investigate and follow the outcome of patients who underwent ultrarapid opiate detoxification (UROD) prospectively.


METHODS
In this randomized clinical trial, 64 patients who underwent UROD were evaluated. The opiate antagonist regimen of naloxone was administered intravenously under general anesthesia, and detoxification was confirmed by naloxone challenge test. All patients were cared in intensive care unit (ICU) for 24 hours, and oral naltrexone was prescribed the next day, after recovery and discharge. Patients were followed up for one month after the procedure. Relapse was considered if routine use of opiates (daily use for at least two weeks) was reported by the patient after detoxification. The data was analyzed by SPSS 16.5 and the study was performed using descriptive analysis and Chi square test.


RESULTS
All 64 participants were opiate-dependent males (ASA physical status of I or II) who aged over 18 years with a mean age of 31.11 ± 8.93 years at the time of UROD. One month after UROD, 48 patients (75%) reported relapse and 16 (25%) reported abstinence; however, four patients of the non-relapsed group reported one episode of opiate use. There was no significant difference between relapsed and non-relapsed patients regarding their marital status, level of education, and family history of opiate dependency (P > 0.05).


CONCLUSIONS
Although UROD by naloxone is a safe and effective method of detoxification, if used alone, it has a very high relapse rate in long term.
Department of Anesthesia and Critical Care, Semnan University of Medical Sciences, Semnan, IR Iran.
Mohammad
M
Forozeshfard
Department of Anesthesia and Critical Care, Semnan University of Medical Sciences, Semnan, IR Iran.
Babak
B
Hosseinzadeh Zoroufchi
Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health, Iran University of Medical Sciences, Tehran, IR Iran.
Mohammad Bagher
MB
Saberi Zafarghandi
Research Center for Social Determinants of Health, Semnan University of Medical Sciences, Semnan, IR Iran.
Razieh
R
Bandari
Department of Pharmacology, School of Medicine, Shahroud University of Medical Sciences, Shahroud, IR Iran.
Behzad
B
Foroutan
Metabolic Detoxification, Drug; Naloxone; Naltrexone; Opioid-Related Disorders; Recurrence