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Detoxification

Eric D. Collins, M.D.; Herbert D. Kleber, M.D.

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Excerpt

Opioid detoxification continues to be employed by the majority of heroin abusers as a pretreatment procedure prior to drug-free treatments, including opioid antagonist maintenance. Some individuals seek detoxification but do not seek long-term treatment, either because they expect to remain opioid-abstinent without additional help or because they do not seriously intend to remain abstinent. For those patients who do seek additional treatment, the prerequisite detoxification and withdrawal discomfort are often a barrier to entering and/or completing treatment. Thus, while detoxification is a necessary part of treatment for many patients, it has not achieved its full potential for the transition from opioid dependence to drug-free and/or antagonist maintenance treatments. The advent of buprenorphine for opioid detoxification may allow this transition to proceed safely, relatively quickly, and with a minimum of discomfort.

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Table Reference Number
Table 14A–1. Signs and symptoms of opioid withdrawal
Table Reference Number
Table 14A–2. Duration of effects and first appearance of withdrawal
Table Reference Number
Table 14A–3. Drug relationships for withdrawal

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