E Lawental1. 1. Haifa Drug Abuse Treatment Center, Rambam Medical Center, Israel.
Abstract
PURPOSE: Ultra rapid detoxification (URD) has recently gained significant media attention as a promising treatment for opiate addiction. URD combined with follow-up naltrexone was portrayed as a quick and painless initial detoxification, as well as a long-term cure for the addiction. Following the therapeutic initiation of URD, articles began to emerge in the scientific literature. URD was skeptically viewed by the substance addiction treatment community, skepticism initially based on the theoretical understanding of addiction as a bio-psycho-social problem and the belief that detoxification and medication alone cannot provide long-term abstinence. This initial response was later supported by some scientific studies. URD continues to stir controversy, leading to this study. METHODS: We used available data to conduct a pilot study of URD, comparing it to traditional 30-day inpatient detoxification programs (IDP) used in Israel in achieving long-term abstinence. A sample of 226 men and women, 18 years or older, who entered detoxification in the IDP (N = 87) or in the URD (N = 139) were all clients who received treatment in either of these programs between March and September 1996. Eighty-one (92%) of the IDP subjects and eighty-two (60%) of the URD subjects were successfully interviewed by telephone 12 to 18 months after their participation in these programs. RESULTS: The results provide preliminary evidence that URD may be much less effective and more expensive than traditional treatment. No specific subgroup of clients benefited more from URD, although a prospective study employing random assignment might be more successful in identifying such a group. IMPLICATIONS: This study appears to offer justification for the current longer-term bio-psycho-social treatment alternatives for opiate addiction.
PURPOSE: Ultra rapid detoxification (URD) has recently gained significant media attention as a promising treatment for opiate addiction. URD combined with follow-up naltrexone was portrayed as a quick and painless initial detoxification, as well as a long-term cure for the addiction. Following the therapeutic initiation of URD, articles began to emerge in the scientific literature. URD was skeptically viewed by the substance addiction treatment community, skepticism initially based on the theoretical understanding of addiction as a bio-psycho-social problem and the belief that detoxification and medication alone cannot provide long-term abstinence. This initial response was later supported by some scientific studies. URD continues to stir controversy, leading to this study. METHODS: We used available data to conduct a pilot study of URD, comparing it to traditional 30-day inpatient detoxification programs (IDP) used in Israel in achieving long-term abstinence. A sample of 226 men and women, 18 years or older, who entered detoxification in the IDP (N = 87) or in the URD (N = 139) were all clients who received treatment in either of these programs between March and September 1996. Eighty-one (92%) of the IDP subjects and eighty-two (60%) of the URD subjects were successfully interviewed by telephone 12 to 18 months after their participation in these programs. RESULTS: The results provide preliminary evidence that URD may be much less effective and more expensive than traditional treatment. No specific subgroup of clients benefited more from URD, although a prospective study employing random assignment might be more successful in identifying such a group. IMPLICATIONS: This study appears to offer justification for the current longer-term bio-psycho-social treatment alternatives for opiate addiction.