In-patient detoxification procedures, treatment retention, and post-treatment opiate use: comparison of lofexidine + naloxone, lofexidine + placebo, and methadone


McCambridge, J; Gossop, M; Beswick, T; Best, D; Bearn, J; Rees, S; Strang, J; (2007) In-patient detoxification procedures, treatment retention, and post-treatment opiate use: comparison of lofexidine + naloxone, lofexidine + placebo, and methadone. Drug and alcohol dependence, 88 (1). pp. 91-5. ISSN 0376-8716 DOI: https://doi.org/10.1016/j.drugalcdep.2006.09.020

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Abstract

OBJECTIVE: In-treatment and post-treatment outcomes were compared for three detoxification procedures (lofexidine+naloxone, lofexidine+placebo naloxone, and methadone). SAMPLE AND DESIGN: The sample was 137 opiate dependent in-patients. Detoxification treatments were 6-day lofexidine+naloxone (n=45), lofexidine+placebo naloxone (n=46), or 10-day methadone reduction (n=46). A cohort study design was used with double-blind random allocation to lofexidine+naloxone versus lofexidine+placebo. Patients who did not consent to, or who were excluded from randomisation received methadone. RESULTS: Outcome differences between treatment groups at follow-up were generally associated with length of stay post-detoxification rather than detoxification procedure. Among patients who were not opiate abstinent throughout follow-up (n=85), those who received lofexidine+naloxone detoxification reported a longer interval to first heroin use, with an interaction between detoxification medication and subsequent retention in treatment also identified. CONCLUSIONS: Detoxification medication may influence medium-term opiate use outcomes via its effect upon retention in treatment.

Item Type: Article
Keywords: Adolescent, Adrenergic alpha-Agonists/*therapeutic use, Adult, Analgesics, Opioid/*therapeutic use, Clonidine/*analogs & derivatives/therapeutic use, Cohort Studies, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Length of Stay, Male, Methadone/*therapeutic use, Middle Aged, Naloxone/*therapeutic use, Narcotic Antagonists/*therapeutic use, Opioid-Related Disorders/*drug therapy, Recurrence, *Substance Abuse Treatment Centers, Substance Withdrawal Syndrome/drug therapy, Treatment Outcome, Adolescent, Adrenergic alpha-Agonists, therapeutic use, Adult, Analgesics, Opioid, therapeutic use, Clonidine, analogs & derivatives, therapeutic use, Cohort Studies, Double-Blind Method, Drug Therapy, Combination, Female, Humans, Length of Stay, Male, Methadone, therapeutic use, Middle Aged, Naloxone, therapeutic use, Narcotic Antagonists, therapeutic use, Opioid-Related Disorders, drug therapy, Recurrence, Substance Abuse Treatment Centers, Substance Withdrawal Syndrome, drug therapy, Treatment Outcome
Faculty and Department: Faculty of Public Health and Policy > Dept of Social and Environmental Health Research
Research Centre: Centre for Global Non-Communicable Diseases (NCDs)
PubMed ID: 17064857
Web of Science ID: 245672800014
URI: http://researchonline.lshtm.ac.uk/id/eprint/9740

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