Historique
Périodique
Accelerated withdrawal from methadone maintenance therapy using naltrexone and minimal sedation: a case-series analysis
(Sevrage accéléré de méthadone par la naltrexone et une sédation minimum : analyse de cas)
Auteur(s) :
GLASGOW, N. J. ;
TAYLOR, J. ;
BELL, J. R. ;
YOUNG, M. R. ;
BAMMER, G.
Année
2001
Page(s) :
213-221
Langue(s) :
Anglais
Domaine :
Drogues illicites / Illicit drugs
Note générale :
Drug and Alcohol Review, 2001, 20, (2), 213-221
Résumé :
FRANÇAIS :
L'objectif de l'étude est d'évaluer le degré d'acceptabilité d'un sevrage de méthadone chez des patients stabilisés, par la naltrexone, le nombre de demandes et le suivi de ces patients sous naltrexone pendant 3 mois. Le protocole a été bien accepté chez les 14 patients étudiés, 4 ont rechuté, mais le rôle de cette forme de maintenance semble toutefois limité.
ENGLISH:
The aim of this study was to measure the acceptability to stable methadone maintenance clients seeking termination of methadone treatment of accelerated withdrawal using a standardized protocol of naltrexone and minimal sedation; and to provide a first assessment of the probable demand for such treatment, characterize the withdrawal experience, and describe the outcomes for the clients using naltrexone for maintenance therapy for 3 months following withdrawal. We used an open label observational study of 14 stable, methadone maintenance programme clients within the Australian Capital Territory. We found a high degree of acceptability of the withdrawal approach to clients and staff. Three phases of withdrawal identified over a 3-week period. There was rapid attrition from naltrexone maintenance over 3 months of follow-up and a return to dependent opiate use in four clients. The protocol is a humane, effective approach to accelerated withdrawal from methadone maintenance. It is a useful modification to ultra-rapid and other rapid withdrawal techniques. Naltrexone maintenance has a limited potential role in this group of subjects. This role also needs further clarification through well-designed randomized clinical trials.
L'objectif de l'étude est d'évaluer le degré d'acceptabilité d'un sevrage de méthadone chez des patients stabilisés, par la naltrexone, le nombre de demandes et le suivi de ces patients sous naltrexone pendant 3 mois. Le protocole a été bien accepté chez les 14 patients étudiés, 4 ont rechuté, mais le rôle de cette forme de maintenance semble toutefois limité.
ENGLISH:
The aim of this study was to measure the acceptability to stable methadone maintenance clients seeking termination of methadone treatment of accelerated withdrawal using a standardized protocol of naltrexone and minimal sedation; and to provide a first assessment of the probable demand for such treatment, characterize the withdrawal experience, and describe the outcomes for the clients using naltrexone for maintenance therapy for 3 months following withdrawal. We used an open label observational study of 14 stable, methadone maintenance programme clients within the Australian Capital Territory. We found a high degree of acceptability of the withdrawal approach to clients and staff. Three phases of withdrawal identified over a 3-week period. There was rapid attrition from naltrexone maintenance over 3 months of follow-up and a return to dependent opiate use in four clients. The protocol is a humane, effective approach to accelerated withdrawal from methadone maintenance. It is a useful modification to ultra-rapid and other rapid withdrawal techniques. Naltrexone maintenance has a limited potential role in this group of subjects. This role also needs further clarification through well-designed randomized clinical trials.
Affiliation :
Academic Unit General Practice Community Care, Calvary Hosp., PO Box 254, Jamison Ctr., ACT 2614
Australie. Australia.
Australie. Australia.