Opioid Treatment Programs detoxification

DEA registration of all Opioid Treatment Programs for the handling of only those narcotic snhstances applied for on the DEA Form 363 and that are approved for use in maintenance or detoxification (see Figure 14-3). 

In a case-control study in 106 heroin-dependent individuals undergoing an opioid detoxification program (n = 19) or a methadone maintenance treatment program (n = 87) there were large significant differences in the mean values of some vitamins and minerals between the heroin-dependent individuals and the healthy, non-dependent controls (37). Dependent individuals had higher white cell counts and transaminases and lower erythrocyte counts and cholesterol, albumin, tocopherol, folic acid, sodium, selenium, and copper concentrations. 

Six cases of complications loosely related to the use of naltrexone pellet implantation during the highly controversial rapid and ultra-rapid opioid detoxification procedures have been reported (22). These included pulmonary edema, prolonged opioid withdrawal states, drug toxicity, withdrawal from cross-dependence to alcohol and benzodiazepines, aspiration pneumonia, and death. The risk of these controversial procedures and of naltrexone in this novel delivery system are high a robust scientifically validated program of research is needed to justify such treatment packages. 

Naltrexone (25 mg initially), a pure narcotic antagonist, is indicated for the treatment of the opioid-free state in formerly opioid-dependent individuals who have undergone a methadone detoxification program. Patients taking naltrexone may not benefit from opioid-containing medicines, such as cough and cold preparations, antidiarrheal preparations, and opioid analgesics. 

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