This application proposes the development of a rule-based interactive computer expert system (DETOX) that will provide assistance to physicians in writing detoxification orders for sedative-hypnotic, opiate and stimulant withdrawal. Inappropriate detoxification protocols can be at best ineffective and at worse lethal. The knowledge required for preparing appropriate detoxification protocols is highly specialized. For many physicians, this knowledge is not readily available. DETOX will provide a means of allowing physicians to easily tap this knowledge. The resulting expected benefits are 1) safer and more accurate detoxification procedures 2) more reliable treatment in that all relevant information will be requested. 3) more rapid delivery of treatment and 4) lower treatment costs by making more efficient use of physician's time. The proposed scope of DETOX's knowledge includes all sedative- hypnotic, opiates, and stimulants in Physician's Desk Reference; the alcohol content of commercially available beers, wines, and liquors; withdrawal protocols, key references to published detoxification protocols; and street drug nomenclature. The expert system will emulate a physician expert in writing detoxification orders. The systems user, in response to computer prompts, will enter the patient's drug history and other medical information needed by the expert system to compute the withdrawal schedule. Output of the system is a detoxification protocol, a summary of medical facts considered in computing the schedule, and the forms needed to clinically monitor the patient during withdrawal. The expert system will be validated by comparing the computer-generated withdrawal schedules to schedules prepared by physician experts.
