Opiate addiction is recognized as a central nervous system disorder, caused by continuous opiate intake. Using opiate for extended periods of time can cause the nerve cells in the brain to stop functioning normally and stop producing natural endorphins. Since the body is receiving opiates and is no longer producing natural endorphins the nerve cells start to degenerate and become physical dependent on opiates.
Sudden withdrawal (quitting cold turkey) leads to a syndrome called withdrawal syndrome. Withdrawal syndrome is a long and painful process and can result in permanent damage to the cardiopulmonary system and the central nervous system. Untreated and unmonitored, it can result in death for unhealthy patients. For these reasons, opiate dependency treatment requires appropriate and responsible medical care.
These symptoms have led to the growth of ultra-rapid, anesthesia-assisted opioid withdrawal procedures. Proponents state that rapid detox is a painless way to withdraw from opioid. However, studies show that the procedure can lead to risk of:
- Increased stress
- Attempted suicide
- Abnormal heart rhythm
- Acute renal failur
- Are very expensive
There are other traditional forms of opiate detoxification including opioid agonist drugs. These include drugs like methadone, levo-alpha-acetylmethadol (LAAM), or Buprenorphine; Clonidine, which blocks some withdrawal symptoms; ultra-rapid opioid detox under anesthesia; and an experimental method using the drug lofexidine. Opioid agonist drugs acts like opiates but do not produce the same high and are administered in doses that are gradually reduced. Since these medications act like opiates there appear to be no noticeable or significantly reduced withdrawal symptoms.
Clonidine can be administered by a transdermal patch, which dispenses the drug gradually and consistently over a seven day period. Patients who choose to use the patch should also take Clonidine orally for the first two days since medications taken through the skin takes two days to reach a steady effectiveness. Monitoring of blood pressure is essential since Clonidine causes hypotension and sedation.
Rapid detox is done under general anesthesia with intubations for six to eight hours. During this time a combination of drugs, usually naltrexone and Clonidine are administered to the patient. Lofexidine, a non-addictive drug brought to the market in 1992, is a centrally acting alpha-2 adrenergic agonist targeted for relief of opiate withdrawal symptoms.
Withdrawal symptoms continue to be the greatest obstacle in heroin detoxification treatment. Studies concur that there is no proof that one detoxification treatment is better than another. Relapses continue to occur in numerous cases around the world therefore making opiate addiction very difficult to treat successfully long term. Studies show that on average addicts will stop and start detox 10-25 times in their lifetime relapsing back to opiate use each and every time.
Opiate detoxification involves:
- Admitting there is a problem
- Seeking medical help
- Staying focused on the goal
- Treatment through a continuing program
Statistics and studies show that there is no easy cure nor is there a guarantee that a relapse will not happen. Support from family, friends and physicians along with the will to succeed are all necessary factors in successful detox regardless of the method chosen. While there are many methods to use for opiate detox, one must choose the method that looks at their general health condition, psychological state, external support and length of time addicted and making an informed decision that best meets the needs.
- http://www.opiates.com/opiate-addiction.html. Opiate Addiction.
- http://www.opiates.com/opiate-withdrawl.html. Opiate Withdrawal Syndrome.
- http://www.asam.org/ AMERICAN SOCIETY OF ADDICTION MEDICINE, INC. Public policy statement on rapid and ultra rapid opioid detoxification ( Formerly Public Policy Statement on Opioid Antagonist Agent Detoxification under Sedation or Anesthesia (OADUSA ))
- Rabinowitz, Jonathan, Hagit Cohen and Moshe Kotler. Outcomes of ultrarapid opiate detoxification combined with naltrexone maintenance and counseling. Psychiatr Serv 49:831-833, June 1998.
- Health Matters, ABC, 2006.