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Efficacy and safety of two new methods of rapid intravenous detoxification in heroin addicts previously treated without success

Published online by Cambridge University Press:  03 January 2018

Albert Seoane ,
Genís Carrasco ,
Lluís Cabré ,
Ana Puiggrós ,
Eustaqui Hernández ,
Miguel Álvarez ,
Josep Costa ,
Ricard Molina  and
Gaudi Sobrepere
Albert Seoane
Affiliation:
PARIS (Professionals Associats per la Rehabilitació i la Salut) Association, Barcelona, Spain
Genís Carrasco*
Affiliation:
Quality of Sedation Research Group, Intensive Care Service, SCIAS-Hospital de Barcelona, Barcelona, Spain
Lluís Cabré
Affiliation:
Quality of Sedation Research Group, Intensive Care Service, SCIAS-Hospital de Barcelona, Barcelona, Spain
Ana Puiggrós
Affiliation:
PARIS (Professionals Associats per la Rehabilitació i la Salut) Association, Barcelona, Spain
Eustaqui Hernández
Affiliation:
PARIS (Professionals Associats per la Rehabilitació i la Salut) Association, Barcelona, Spain
Miguel Álvarez
Affiliation:
PARIS (Professionals Associats per la Rehabilitació i la Salut) Association, Barcelona, Spain
Josep Costa
Affiliation:
Quality of Sedation Research Group, Intensive Care Service, SCIAS-Hospital de Barcelona, Barcelona, Spain
Ricard Molina
Affiliation:
Quality of Sedation Research Group, Intensive Care Service, SCIAS-Hospital de Barcelona, Barcelona, Spain
Gaudi Sobrepere
Affiliation:
Quality of Sedation Research Group, Intensive Care Service, SCIAS-Hospital de Barcelona, Barcelona, Spain
*
Dr G. Carrasco, Intensive Care Service, SCIAS-Hospital de Barcelona, Avda Diagonal 660, 08034 Barcelona, Spain
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Abstract

Background

New methods of rapid opiate detoxification, under intravenous sedation, can detoxify heroin-addicted patients in 24 hours. Their clinical application has been limited by the lack of studies establishing both efficacy and safety.

Method

In a randomised, controlled study, 300 treatment-refractory, heroin-addicted patients received rapid intravenous detoxification treatment (naloxone infusion, 0.06–0.08 mg/kg, then oral naltrexone 50 mg/day) under either monitored light intravenous sedation or unmonitored deep intravenous sedation.

Results

All patients were successfully detoxified and 93% remained abstinent one month later. Severity of withdrawal, according to the Wang Scale modified by Loimer, was 4.9 (s.d. 3.0) points in the light sedation group and 4.8 (s.d. 2.9) in the deep sedation group (P=0.26). Two patients (1.3%) in the light sedation group and four (2.6%) in the deep sedation group required tracheal intubation (P=0.31). There was only one severe complication, a case of nosocomial aspirative pneumonia which improved with antibiotic treatment.

Conclusions

Successful rapid intravenous detoxification can be achieved using relatively light levels of sedation.

Type
Papers
Information
The British Journal of Psychiatry , Volume 171 , Issue 4 , October 1997 , pp. 340 - 345
Copyright
Copyright © 1997 The Royal College of Psychiatrists 

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Footnotes

∗

Presented, in part, at the XV Annual Meeting of the Catalan Intensive Care Society, Barcelona, November 24–25, 1994.

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