This study is a 30 patient """"""""innovative therapy"""""""" protocol in which the feasibility, efficacy, and safety of rapid opiate withdrawal intervention will be tested. The proposal will utilize general anesthesia to supress withdrawal symptoms, while the patient is rapidly detoxified pharmacologically. Continuing Review as of 2/20/99 for this project reveals that 7 human subjects (5 males, 1 female) have been enrolled to date. The investigators report that 6 patients with opioid dependence received URD and participated in a 12 week course of outpatient psychotherapy. REsults: URD paroduced a trend towards elevated systolic (p=0.07) and diastolic (p=-0.07) blood pressure and no significant changes in heart rate (p=-0.12). Six patients remained abstinent and compliant wsith naltrexone treatment 12 weeks later. Significant withdrawal persisted for 4 weeks, while self reported ratings of craving for opioids were consistently rated """"""""none"""""""" to """"""""mild"""""""". Hamilton Rating Scales for Depression and Anxiety and Beck Depression Inventory scores declined significantly during a 12 week follow-up period and self-reported sleep and appetite improved significantly after 10 days. Conclusions: UD produced minimal hemodynamic response. The findings that this procedure does not completely eliminate withdrawal symptoms has important implications for addictions treatment integration and policy. The fact that URD and subsequent treatment with naltrexone does dissociate craving from with drawal has implications for behavioral pharmacology. All patients' procedures summaries have been submitted to the HRC.
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