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Influence of the dose on the severity of opiate withdrawal symptoms during methadone detoxification
Anthony Glasper1, Michael Gossop, Cornelis de Wet
1National Addiction Centre, London, UK. Anthony.Glasper@sussexpartnership.nhs.uk
Aim:
This study investigates factors influencing the severity of opiate withdrawal symptoms, focusing on the relationship between methadone dose and withdrawal severity among opiate-dependent in-patients receiving methadone detoxification.
Methods:
The sample comprised 48 opiate-dependent patients admitted to a specialist in-patient drug treatment service and withdrawn from opiates, using a 10-day methadone reduction schedule. The severity of withdrawal symptoms was assessed daily using the Short Opiate Withdrawal Scale.
Results:
Patients withdrawn from higher doses of methadone and those reporting higher levels of anxiety reported more severe withdrawal symptoms. No relationship was found between methadone dose and completion of detoxification or length of hospital stay.
Conclusions:
Although patients on higher doses of methadone reported more severe opiate withdrawal symptoms than patients on lower doses, the dose effect accounted for only a small percentage of the total variance. Nonetheless, the finding of a dose-response effect supports one of the basic principles of clinical practice during detoxification, namely the matching of the medication withdrawal schedule to the pre-admission opiate dose.
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