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Outpatient methadone withdrawal for heroin dependence
The American Journal of Drug and Alcohol Abuse
|January 1, 1980
Summary
Outpatient methadone withdrawal for heroin users showed varied success rates in the 1970s. Studies suggest it did not consistently lead to prolonged abstinence, with some patients resuming heroin use after early withdrawal.
Area of Science:
- Addiction Medicine
- Pharmacology
- Public Health
Background:
- Methadone withdrawal is a common treatment for opioid dependence.
- Previous studies on outpatient methadone withdrawal outcomes in the 1970s showed significant variability.
- The effectiveness of outpatient versus inpatient withdrawal for opioid users requires further investigation.
Purpose of the Study:
- To evaluate the outcomes of outpatient methadone withdrawal.
- To compare opioid use and related behaviors before and after outpatient withdrawal.
- To assess the long-term abstinence rates following outpatient methadone treatment.
Main Methods:
- Review of 20 published studies on outpatient methadone withdrawal from the 1970s.
- Two comparative studies in San Antonio assessing opioid use and behavior over one year pre- and post-withdrawal.
- Analysis of arrest records and follow-up data to determine abstinence and treatment maintenance.
Main Results:
- Outcomes of outpatient methadone withdrawal varied widely, with completion rates from 0% to 62%.
- Abstinence rates at termination ranged from 0% to 35%, and at follow-up from 0% to 38%.
- One study showed no increase in abstinence but a significant increase in methadone maintenance, with outcomes similar to inpatient withdrawal. Arrest rates remained stable.
Conclusions:
- Outpatient methadone withdrawal did not consistently result in prolonged abstinence for most heroin users.
- A 21-day limit for outpatient withdrawal may lead to premature cessation and relapse.
- Methadone maintenance may be a more effective outcome than short-term outpatient withdrawal for some individuals.