From the Literature: Opioid Addiction

Review the key findings from four recently published studies looking at Opioid Addiction.

Effect of Ultra-rapid Opiate Detoxification on Withdrawal Syndrome

Journal: Journal of Addictive Diseases (October 29, 2010)

Authors: Safari F, Mottaghi K, Malek S, et al

Purpose: The study was designed to examine the effect of ultra-rapid opiate detoxification (UROD) “on the presence or absence of withdrawal syndrome in a group of patients with opiate dependency.”

Results: The study included 173 patients with opiate addiction. The participants were evaluated both before and after UROD “using the Objective Withdrawal Scale.” The most prevalent withdrawal sign before UROD was anxiety. The researchers found that the opioid dependent patients that “underwent UROD showed the highest rate of withdrawal symptoms at one hour after anesthesia. Most of these symptoms subsided after 24 hours.” They concluded that for opioid dependent patients “UROD can be applied for detoxification with safety.”

Characteristics of Prescription Opioid Abusers in Treatment: Prescription Opioid Use History, Age, Use Patterns, and Functional Severity

Journal: Journal of Opioid Management (July-August 2010)

Authors: Butler S, Black R, Serrano J, et al

Purpose: The study is designed to examine whether prolonged use of prescription opioid drugs leads to, or is associated with, “abuse of other drugs” and increases “more risky drug-related behavior, and more functional problems.”

Results: The researchers examined data from the Addiction Severity Index-Multimedia Version Connect system. The team had access to 55,341 client assessments at substance abuse treatment centers. The researchers concluded that “Overall findings supported the hypothesis that length of opioid abuse is associated with higher risk of drug use patterns as well as functional problems.”

A Clinical Trial Comparing Tapering Doses of Buprenorphine with Steady Doses for Chronic Pain and Co-existent Opioid Addiction

Journal: Journal of the American College of Cardiology (September 2010)

Authors: Blondell R, Ashrafioun L, Dambra C, et al

Purpose: The study compares the effects of discontinuing opioids and the effectiveness of opioid replacement protocols.

Results: The team enrolled participants into one of two six-month treatment protocols of buprenorphine/naloxone sublingual tablets. The participants had been treated with opioids for chronic non-cancer pain and had an opioid addiction. One group received tapering doses for detoxification and the other group received “steady doses for opioid replacement.” Based on the results, the researchers concluded that the participants “were more likely to adhere to an opioid replacement protocol.” Additionally, the second group demonstrated “improved pain control and physical functioning.”

Quality of Life Under Maintenance Treatment with heroin versus Methadone in Patients with Opioid Dependence

Journal: Drug and Alcohol Dependence (August 19, 2010)

Authors: Karow A, Reimer J, Schäfer I, et al

Purpose: The researchers sought to examine health-related quality of life (HRQOL) in patients with “severe opioid dependence” through a longintudinal study.

Results: The 938 participants were randomly assigned to four groups of medical and psychosocial treatment. The groups were: “heroin (diacetylmorphine) versus methadone and case management (CM) versus psychoeducation (PSE) respectively.” The results revealed that while both forms of maintenance and psychosocial treatment improved HRQOL during the observation peroid,” maintenance with heroin improvement in HRQOL exceeded maintenance with methadone. Additionally, HRQOL improved HRQOL significantly “in subjects treated with PSE compared with CM.”

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