Detoxification from Methadone Maintenance: Current and Innovative Approaches

Abstract

Detoxification from opiates has created difficulties for as long as these drugs have been available for the relief of pain or the production of euphoria. Although the withdrawal syndrome is rarely life threatening, its symptoms are distressing enough in the acute phase to make it difficult for many addicted individuals to cease use of drugs, and the chronic persistence of low-level symptoms has no doubt been a contributing factor to early relapse. The withdrawal “cures” proposed over the last 100 years have at times been worse than the disease, introducing drugs which are even more addicting or using other methods that either cause more distress or even at times a significant mortality rate. Examples of the former include the use of injectable morphine to cure opium eating (Allbutt, 1870) and the use of heroin to treat morphine addiction (Kramer, 1977); while examples of the latter include the Towns-Lambert belladonna mixture, Narcosan, sodium thiocyanate (Kolb and Himmelsbach, 1938), and electroconvulsive therapy (Thigpen et al, 1953). Because of this distressing history, one must be especially careful in proposing new techniques that they meet the twin demands of safety and efficacy. Any claims for a new method should be put forward with modesty and viewed with skepticism until amply documented by careful experimental procedures.