Comparison of linear versus inverse exponential methadone reduction curves in the detoxification of opiate addicts.

A linear methadone detoxification procedure is compared with an inverse exponential reduction curve in a double-blind study. The inverse exponential curve resulted in withdrawal symptomatology which was significantly greater during the acute phase of the opiate withdrawal curve and was not significantly different during the recovery phase. There was no difference between groups in the time course of the withdrawal syndrome, in peak symptom severity, nor in patient compliance.

The detoxification of high dose heroin addicts in Pakistan.

Treatment services in Pakistan have been swamped by the recent appearance and rapid growth of heroin abuse, and there is an urgent need to initiate and strengthen effective responses. This paper presents the results of an exercise in national monitoring of heroin detoxification services in Pakistan. The study also offers the first systematic description of the withdrawal response of heroin addicts dependent upon doses greatly in excess of those reported in developed countries.

Opiate withdrawal symptoms in response to 10-day and 21-day methadone withdrawal programmes.

This study investigates and compares the responses of 132 opiate addicts to a 10-day or a 21-day in-patient oral methadone withdrawal regime. For both groups, symptom severity (on the Opiate Withdrawal Scale) steadily increased through the methadone withdrawal phase, and peaked near the point of completion of the prescribed drug, declining slowly thereafter. Patients on the 10-day programme reported significantly higher peak withdrawal scores than those on the 21-day programme.

Circumstances surrounding the initial lapse to opiate use following detoxification.

Seventy-eight opiate abusers were followed up after successful in-patient detoxification in order to examine renewed opiate use. The greatest number of initial lapses occurred within a week of subjects leaving in-patient treatment. Eleven categories of lapse precipitant were identified: cognitive, mood, external, withdrawal, interpersonal, leaving a protected environment, drug availability, drug-related cues, craving, priming, and social pressure.

Lapse, relapse and survival among opiate addicts after treatment. A prospective follow-up study.

This paper presents data from the first British prospective study to investigate relapse among opiate addicts after treatment. Eighty subjects were followed up over the six-month period immediately after discharge from treatment and were interviewed on several occasions. Large numbers of subjects used opiates within a very short time after discharge; 71% used them within the first six weeks.

Clonidine and the treatment of the opiate withdrawal syndrome.

Clonidine is a central alpha adrenergic agonist which can be used to treat the opiate withdrawal syndrome. It has been used in many controlled trials and a substantial body of research evidence is available about its effectiveness in this role. This paper reviews the literature regarding its introduction in the Yale studies, its effectiveness relative to gradual methadone reduction treatments, its side effects, and touches briefly upon its use in conjunction with opiate antagonists.

What happens to opiate addicts immediately after treatment: a prospective follow up study.

In the first British study to investigate systematically what happens to opiate addicts after treatment 50 opiate addicts admitted for inpatient treatment of their drug dependence were followed up for six months after discharge. All had been withdrawn from opiates before follow up. Six months later 26 were not using opiates: 12 had not used opiates at any time since discharge.

An investigation of withdrawal symptoms shown by opiate addicts during and subsequent to a 21-day in-patient methadone detoxification procedure.

Methadone detoxification procedures are widely accepted as a satisfactory way of withdrawing opiate addicts from drugs. There have, however, been comparatively few empirical studies which have examined the development and course of withdrawal symptoms in opiate addicts in response to such detoxification procedures. This study investigates the opiate withdrawal syndrome in a group of 116 opiate addicts during and subsequent to a gradual oral methadone detoxification programme.

The influence of psychological factors on the opiate withdrawal syndrome.

Psychological and drug-related variables and their effect on the severity of withdrawal symptoms were examined in a group of addicts being withdrawn from opiates on an in-patient drug dependence unit. Two psychological factors--neuroticism and the degree of distress expected by the patient--were related to subsequent severity of symptoms. Both are anxiety-related, and may serve to amplify withdrawal symptoms.

Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment.

The relative effectiveness of an inpatient and an outpatient withdrawal programme for opiate addicts was studied. Forty five men and 15 women (mean age 26.13 (SD 5.