Accelerated withdrawal from methadone maintenance therapy using naltrexoneand minimal sedation: a case-series analysis

Glasgow, NJ Taylor, J Bell, JR Young, MR Bammer, G

Nj. Glasgow et al., Accelerated withdrawal from methadone maintenance therapy using naltrexoneand minimal sedation: a case-series analysis, DRUG AL REV, 20(2), 2001, pp. 213-221

22

INGLESE

Article

Public Health & Health Care Science

DRUG AND ALCOHOL REVIEW

0959-5236 → ACNP

20

2

2001

213 - 221

ISI

0959-5236(200106)20:2<213:AWFMMT>2.0.ZU;2-9

The aim of this study was to measure the acceptability to stable methadone maintenance clients seeking termination of methadone treatment of accelerat ed withdrawal using a standardized protocol of naltrexone and minimal sedat ion; and to provide a first assessment of the probable demand for such trea tment, characterize the withdrawal experience, and describe the outcomes fo r the clients using naltrexone for maintenance therapy for 3 months followi ng withdrawal. We used an open label observational study of 14 stable, meth adone maintenance programme clients within the Australian Capital Territory . We found a high degree of acceptability of the withdrawal approach to cli ents and staff. Three phases of withdrawal identified over a 3-week period. There was rapid attrition from naltrexone maintenance over 3 months of fol low-up and a return to dependent opiate use in four clients. The protocol i s a humane, effective approach to accelerated withdrawal from methadone mai ntenance. It is a useful modification to ultra-rapid and other rapid withdr awal techniques. Naltrexone maintenance has a limited potential role in thi s group of subjects. This role also needs further clarification through wel l-designed randomized clinical trials.