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ultra rapid opioid detoxification

Leila Ghamati, Vahid Hajali, Vahid Sheibani, Khadijeh Esmaeilpour, Gholamreza Sepehri, Mojtaba Shojaee
BACKGROUND: Opioids have been shown to affect learning and memory processes. Different protocols of morphine withdrawal can substantially vary in their success to prevent opioid induced impairments of cognitive performance. In the present study, we report the effects of single and repetitive ultra-rapid detoxification (URD) on spatial learning and memory in morphine addicted rats. METHODS: Morphine (10 mg/kg) was intraperitoneally (IP) injected in male rats once a day over one week and after which they were detoxified with naloxone administration under anesthesia...
2014: Addiction & Health
Alireza Salimi, Farhad Safari, Seyed Amir Mohajerani, Morteza Hashemian, Ali-Asghar Kolahi, Kamran Mottaghi
Ultra-rapid opioid detoxification (UROD) and subsequently induction of naltrexone maintenance therapy can be regarded as a safe and effective detoxification method for use in patients with opiate addiction. Long-term efficacy, relapse time, and relapse rate of this method is not clear. The aim of this article was to assess UROD efficacy and estimate the relapse rate in the 2-year follow-up period. Opioid-addicted, self-reporting patients referred to our hospital center were enrolled. All demographic data were collected by direct interview and based on patients' official documents...
2014: Journal of Addictive Diseases
Dalia Abdelhamid Mohamed Nasr, Hani Abdelfattah Said Ahmed Omran, Sameh Michel Hakim, Waleed Ahmed Abdelrahman Mansour
BACKGROUND: In this study, ultra-rapid detoxification using dexmedetomidine under general anesthesia (GA) has been evaluated in preventing the withdrawal symptoms in patients addicted to opioids. METHODS: Sixty male patients who were addicted to opioids were assigned to one of the two groups, in which anesthesia was induced and maintained using propofol infusion: group D = treated with dexmedetomidine during anesthesia and for 6 days after recovery from anesthesia; group C = control group treated after recovery from anesthesia with oral dose of lefoxidine 0...
September 2011: Journal of Opioid Management
Christopher V Maani, Peter A DeSocio, Richard K Jansen, Jason D Merrell, Laura L McGhee, Alan Young, James F Williams, Katie Tyrell, Bonnie A Jackson, Maria L Serio-Melvin, Lorne H Blackbourne, Evan M Renz
BACKGROUND: The purpose of this case series was to review the management of burn patients who requested ultrarapid opioid detoxification under anesthesia after extended duration of narcotic use for chronic pain related to burn injury. METHODS: The treatment plan of six opioid-dependent burn patients was analyzed to assess the effectiveness of our detoxification practice to date. Demographic and clinical information was used to characterize the patient population served: age, burn size, injury severity, duration of narcotic use before detoxification intervention, and length of hospitalization stay...
July 2011: Journal of Trauma
Karim Nasseri, Behzad Ahsan, Fariba Farhadifar, Shoaleh Shami
Ultra rapid opioid detoxification (UROD) is one of the new methods of detoxification. This method of detoxification involves putting patients under general anesthesia and actively giving them opioid antagonists. The objective of this study was to evaluate effects of anesthesia duration in UROD on severity of withdrawal syndrome. Sixty addicted patients seeking UROD procedure assigned randomly to one of the 2 hr, 4 hr or 6 hr anesthesia duration groups. Premedication and anesthesia procedure (induction and maintenance) were the same for three groups...
January 2010: Acta Medica Iranica
Farhad Safari, Kamran Mottaghi, Saeed Malek, Alireza Salimi
The aim of study was determine the effect of ultra-rapid opiate detoxification (UROD) on the presence or absence of withdrawal syndrome in a group of patients with opiate dependency. In this study, withdrawal syndrome of 173 patients with opiate addiction was evaluated before and after UROD using the Objective Opioid Withdrawal Scale. Hence, each patient was observed for 5 minutes before UROD and at different hours afterward to observe any withdrawal sign. The most prevalent withdrawal sign before UROD was anxiety...
October 2010: Journal of Addictive Diseases
A Naderi-Heiden, A Naderi, M M Naderi, F Rahmani-Didar, A-R Salimi, A Gleiss, S Kasper, R Frey
INTRODUCTION: The aim of this retrospective study was to assess ultra-rapid opiate detoxification (UROD) and to estimate the retention rate in naltrexone maintenance treatment. METHODS: 45 opiate-addicted male patients (DSM-IV 304.00; opiate per oral or per inhalation n=40, heroin intravenous n=5; concomitant cannabis abuse n=6) were detoxified by 6 h of naloxone infusion under general anesthesia with midazolam, propofol, clonidine and atracurium. Withdrawal signs were evaluated by the objective opiate withdrawal scale (OOWS, range 0-13) up to 24 h after awakening...
June 2010: Pharmacopsychiatry
Anthony Plunkett, Michael Fahlgren, Brian McLean, Derick Mundey
OBJECTIVE: To perform an opioid-free, balanced anesthetic for an Active Duty soldier undergoing cervical ganglionectomy for intractable occipital neuralgia 7 days after ultra rapid opioid detoxification (UROD) under general anesthesia. SETTING: Opioids have been a mainstay for both intraoperative and postoperative analgesia. With the emergence of newer non-opioid analgesics and the practice of the multimodal analgesia, opioid therapy will be complimented and, in some cases, replaced by these newer agents...
May 2009: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
Eveline L A van Dorp, Ashraf Yassen, Albert Dahan
Naloxone is a non-selective, short-acting opioid receptor antagonist that has a long clinical history of successful use and is presently considered a safe drug over a wide dose range (up to 10 mg). In opioid-dependent patients, naloxone is used in the treatment of opioid-overdose-induced respiratory depression, in (ultra)rapid detoxification and in combination with buprenorphine for maintenance therapy (to prevent intravenous abuse). Risks related to naloxone use in opioid-dependent patients are: i) the induction of an acute withdrawal syndrome (the occurrence of vomiting and aspiration is potentially life threatening); ii) the effect of naloxone may wear off prematurely when used for treatment of opioid-induced respiratory depression; and iii) in patients treated for severe pain with an opioid, high-dose naloxone and/or rapidly infused naloxone may cause catecholamine release and consequently pulmonary edema and cardiac arrhythmias...
March 2007: Expert Opinion on Drug Safety
J Singh, D Basu
Opioid dependence is a major health problem and a cause of increasing concern to physicians and other health professionals worldwide. A crucial first step in intervention is detoxification. Recent trends in medical practice have seen the emergence of newer techniques that claim to accelerate the detoxification procedure and ensure prevention of relapse by rapid induction onto maintenance treatment with opioid antagonists such as naltrexone. This review delves into the theoretical and methodological aspects related to ultra-rapid opioid detoxification (opioid detoxification procedure using opioid antagonists, performed under general anaesthesia or heavy sedation) and discusses the status of the same in light of the available evidence regarding its applicability, safety and effectiveness...
July 2004: Journal of Postgraduate Medicine
Emmanuel Streel, Paul Verbanck
Rapid or ultra-rapid opiate detoxification has become increasingly popular in both private and public addiction centres. These techniques seem to facilitate the transfer of opiate-dependent patients from opiate agonist to opiate antagonist. Despite the probable complex neuropharmacological aspects involved in these procedures, their development over nearly three decades is notable for the almost complete absence of clinically relevant animal studies. This paper discusses the historical background of this occurrence, and reviews the small number of animal studies that have been conducted...
June 2003: Addiction Biology
Hong Ma, Jun Tang, Paul F White, Ronald H Wender, Thomas Leverone, Rayond Quon, Scott Pearce, Franklin Chiao, Susan Erice
Clonidine, an alpha(2)-adrenergic agonist, is used to minimize withdrawal symptoms related to ultra-rapid opioid detoxification procedures. These preliminary data suggest that clonidine possesses dose-related antidiarrheal activity.
May 2003: Anesthesia and Analgesia
C Bochud Tornay, B Favrat, M Monnat, J B Daeppen, C Schnyder, G Bertschy, J Besson
BACKGROUND: New methods of ultra-rapid opiate detoxification (URD) under intravenous sedation have been criticized because of limited data on safety and long-term follow-up. Premedication with buprenorphine has been advocated to improve safety by decreasing vomiting. Prior research has not explored URD in socially impaired patients. METHOD: Sixteen patients were detoxified with URD and prospectively evaluated over at least 30 months. Data of this procedure were compared with those of our previous study without buprenorphine preparation (Drug Alcohol Depend...
April 1, 2003: Drug and Alcohol Dependence
A I Golovko, L V Leont'eva, S I Golovko, S Iu Zefirov, D A Konoplin, O P Romanenko
Ultra rapid opioid detoxification (UROD) is a new technique with the use of mu-opioid receptor antagonists to precipitate withdrawal. The scientific literature on UROD techniques in opiate addicts are reviewed, but little has been published on its neurochemical aspects. It is discussed that exposure to naloxone ore naltrexone during UROD is associated with development of increasing in opioidergic neurotransmission. On the other hand, ultra rapid opioid detoxification can be accompanied by normalization of joined brain neurotransmitter systems: noradrenergic, serotoninergic, GABAergic, cholinergic and glutamatergic neurotransmission systems...
March 2002: Voprosy Medit︠s︡inskoĭ Khimii
Jonathan Rabinowitz, Hagit Cohen, Shmuel Atias
Relapse rates of 30 opiate-addicted social service clients who were given a 9-month course of naltrexone after being rapidly detoxified using naltrexone + clonidine under anesthesia were compared to 33 similar clients detoxified in a 30-day intensive inpatient detoxification but not given naltrexone. Both groups had the same counseling aftercare. Telephone follow-up of 26 of the intensive inpatient detoxification clients and 24 of the rapidly detoxified clients found no significant differences (p = .62) in relapse rates, with 34% of respondents returning to regular opiate use 13...
2002: American Journal on Addictions
E Pinto, J Reggers, M Delhez, S Fuchs, I Venneman, M Lamy, M Ansseau
Many studies support the hypothesis of a substantial benefit in inducing an Opiate Receptor Blockade through a Rapid Opiate Detoxification under general Anaesthesia (RODA) in opiate dependent patients. However, prospective studies and long term evaluation of the technique are lacking. In order to evaluate long-term abstinence rates after a RODA among a sample of opiate addicts, a study was started in March 1999 at the University of Liège. To date, 45 patients were evaluated (mean age: 29 +/- 5 years) with a mean opiate dependence duration of 8 +/- 4 years...
August 2001: Revue Médicale de Liège
E Fontaine, I O Godfroid, R Guillaume
UNLABELLED: Ultra-rapid opioid detoxification (UROD) is an increasingly popular technique for detoxifying patients addicted to opiates. This technique aims at reducing not only the duration but also the intensity of withdrawal by using general anesthesia coupled with a naloxone or naltrexone medication. In this paper the authors attempt to review the history of UROD and the logic of its procedure and results whilst also demonstrating its advantages and limits. METHOD: The MEDLINE database was searched from 1966 to 2000 using the terms "ultra-rapid opioid detoxification, rapid opioid detoxification under anesthesia, naloxone, naltrexone, opioid-related disorders"...
March 2001: L'Encéphale
G Pozzi, G Conte, S De Risio
Trazodone is a non-tricyclic antidepressant drug with specific antagonistic activities at 5-HT(2) and alpha-1 adrenoceptors. We test the efficacy of trazodone (T) compared with clonidine (C) in rapid opiate detoxification (ROD) from methadone after reduction to a daily maintenance dose </=20 mg. Forty five inpatients were consecutively assigned either to T (n=30) or to C (n=15) treatment in a 7-day ROD protocol with naltrexone administration starting at day 4. The maximum daily dosage was 800 mg for T and 1...
June 1, 2000: Drug and Alcohol Dependence
A P Albanese, C Gevirtz, B Oppenheim, J M Field, I Abels, J C Eustace
OBJECTIVES: (1) Evaluate the safety and efficacy of Ultra Rapid Opiate Detoxification (UROD); and (2) evaluate six month outcome data of patients choosing this method. DESIGN: Two center parallel group clinical trial. No grant funding. SETTING: Two academic medical centers. PARTICIPANTS: Ninety-three men and 27 women, aged 18 to 55 years, with opiate dependency self selected to undergo detoxification. INTERVENTIONS: UROD followed by naltrexone maintenance and an aftercare program...
2000: Journal of Addictive Diseases
N Scherbaum, S Klein, H Kaube, P Kienbaum, J Peters, M Gastpar
This study was done in order to examine the hypothesis that so-called ultra-rapid opiate detoxification provides a mild, short, and safe withdrawal. A total of 22 patients who were addicted to opiates exclusively underwent ultra-rapid detoxification. Each patient was pretreated with methadone. During general anesthesia lasting about six hours with methohexital or propofol, naloxone was administered with doubling of the dose every 15 minutes with a starting bolus dose of 0.4 mg. The total bolus dose of 12.4 mg, delivered within 60 minutes, was followed by a naloxone infusion of 0...
November 1998: Pharmacopsychiatry
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