Methadone at tapered doses for the management of opioid withdrawal

Amato, Laura; Davoli, Marina; Ferri, Marica; Ali, Robert

doi:10.1002/14651858.cd003409.pub2

Cited by 58 publications

(68 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There are good-quality systematic reviews of the main pharmacotherapeutic approaches: methadone at tapered doses (Amato et al, 2005) (Ia), buprenorphine tapering (Gowing et al, 2009a) (Ia) and symptomatic treatment with α2 adrenergic agonists (Gowing et al, 2009b) (Ia). There is also a small number of small RCTs of SROM and one of dihydrocodeine.…”

Section: Management Of Withdrawal From Opioid Drugsmentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

View full text Add to dashboard Cite

The British Association for Psychopharmacology guidelines for the treatment of substance abuse, harmful use, addiction and comorbidity with psychiatric disorders primarily focus on their pharmacological management. They are based explicitly on the available evidence and presented as recommendations to aid clinical decision making for practitioners alongside a detailed review of the evidence. A consensus meeting, involving experts in the treatment of these disorders, reviewed key areas and considered the strength of the evidence and clinical implications. The guidelines were drawn up after feedback from participants. The guidelines primarily cover the pharmacological management of withdrawal, short-and long-term substitution, maintenance of abstinence and prevention of complications, where appropriate, for substance abuse or harmful use or addiction as well management in pregnancy, comorbidity with psychiatric disorders and in younger and older people. KeywordsSubstance misuse, addiction, guidelines, pharmacotherapy, comorbidity 1 Imperial College London, CNWL NHS Foundation Trust, London, UK 2 Gether NHS Foundation Trust, Gloucester, UK 3 Pennine Care NHS Foundation Trust, Ashton-under-Lyne, UKOther invited participants at the consensus meeting who contributed to the discussion and commented on the guidelines were Drummond C, Farrell M, Gilvarry E, Strang J. John, a user representative, read and commented on the written guidelines. Prof W van den Brink reviewed the written guidelines.

show abstract

Section: Management Of Withdrawal From Opioid Drugsmentioning

confidence: 99%

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

Welch²,

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Although detoxification has been found to be effective in reducing the symptoms of opioid withdrawal, it is not an effective treatment for opioid dependence (Amato et al, 2005b). Because it is widely used but not effective, it is helpful to include methadone detoxification as a routine care control group in studies evaluating methadone maintenance.…”

Section: Methadone Detoxificationmentioning

confidence: 99%

A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

Gruber

Delucchi

Kielstein³

et al. 2008

Drug and Alcohol Dependence

View full text Add to dashboard Cite

Background-Important questions remain regarding the necessary duration and intensity for methadone treatment to be effective. (Batki et al., 2002), patients with opioid dependence were recruited from an outpatient 21-day methadone detoxification program and were randomly assigned to one of three treatment conditions: 1) continuation in 21-day methadone detoxification; 2) transfer to six-month methadone maintenance with only minimal counseling; or 3) transfer to six-month methadone maintenance with standard twice monthly counseling and as-needed social work and psychiatric services. Both of the six-month maintenance treatments were followed by 1.5 months of detoxification. Urine drug tests and self-report measures were collected at baseline, months 1 through 6, and month 8.5. Methods-As part of a clinical trial of tuberculosis chemoprophylaxisResults-Compared to 21-day methadone detoxification, six-month methadone maintenance with either minimal or standard counseling resulted in fewer opiate positive urine tests and days of selfreported heroin and alcohol use. There was no change in cocaine use or other outcome measures. The increased counseling available in the standard counseling condition did not appear to reduce heroin use further than the minimal counseling condition, in contrast to the effect found for more structured counseling in long-term methadone maintenance (McLellan et al., 1993).Conclusions-Six months of methadone maintenance, even with minimal counseling, reduces heroin and alcohol use more than 21-day methadone detoxification.

show abstract

“…Centers often combine these treatments as a first stage of any therapy, presumably to establish a better relationship with patients and to increase motivation and acceptance of therapy itself. However, these treatments do not allow to maintain long-term abstinence (Amato, Davoli, Minozzi, Ali, and Ferri, 2005;Caplehorn, McNeil, and Kleinbaum, 1993;D'Ippoliti, Davoli, Perucci, Pasqualini, and Bargagli, 1998) and do not ensure good compliance to treatment; in the VEdeTTE study subjects receiving AOT did not continue these therapies for more than 100 days and showed the worst retention. The limited retention of AOT could be inherent to treatment, since it is aimed at abstinence, and consequently is a definitive recovery associated with treatment, 2 but, considering the short term of the VEdeTTE follow-up, it is properly a failure.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Therapies for Heroin Addiction in Retaining Patients in Treatment: Results From the VEdeTTE Study

Salamina¹,

Diecidue²,

Vigna‐Taglianti³

et al. 2010

Substance Use & Misuse

View full text Add to dashboard Cite

show abstract

Methadone at tapered doses for the management of opioid withdrawal

Cited by 58 publications

References 47 publications

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

BAP updated guidelines: evidence-based guidelines for the pharmacological management of substance abuse, harmful use, addiction and comorbidity: recommendations from BAP

A randomized trial of 6-month methadone maintenance with standard or minimal counseling versus 21-day methadone detoxification

Effectiveness of Therapies for Heroin Addiction in Retaining Patients in Treatment: Results From the VEdeTTE Study

Contact Info

Product

Resources

About