Study Shows Outpatient Detox Combined With Therapy Works for Painkiller Dependence
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A recent clinical trial funded by the National Institute on Drug Abuse has shown a combination of precise outpatient Suboxone-supported detoxification followed by post-detox naltrexone therapy engenders impressive results for people dependent on opioid painkillers.
The combination treatment plan has resulted in lasting abstinence with much higher rates of success than found in typical detox regimens. What's more interesting, the duration of the taper period proved to be a determinate factor in the success; the longer the taper period of the Suboxone, the greater the success of ongoing abstinence.
Backed by NIDA and conducted by Dr. Stacey Sigmon at the University of Vermont in Burlington, the study enrolled 70 patients into a double-blind, randomized clinical trial with a three-step detoxification process. First, the patient’s cravings were stabilized with Suboxone to suppress withdrawal symptoms. Second, the patient experienced a gradual tapering of the Suboxone dosages. Once a patient tested negative, the shift was made to post-detox naltrexone therapy. A non-opioid medication, naltrexone blocks the opioid receptors in the brain.
Of the patients assigned to the four-week taper, 50% were opioid-abstinent at the end of the 12-week trial. "Outpatient detoxification can be effective," Dr. Sigmon said. "This finding may hold particular relevance for prescription opioid abusers, many of whom are younger and have briefer histories of opioid dependence, less severe other drug use, less IV use, and greater psychosocial stability than past generations of primary heroin abusers.”
Dr. Will Aklin, acting chief in NIDA’s Behavioral and Integrative Treatment Branch, says the findings of Dr. Sigmon’s team represent a meaningful advance toward meeting that challenge. As the Vermont study expresses in its conclusion, “Our results suggest that a subset of PO (prescription opioid) abusers may respond favorably to a brief but carefully crafted outpatient treatment involving buprenorphine detoxification, naltrexone maintenance, and behavioral therapy.”