Golden Scott A, Sakhrani Duru L
Center for Treatment of Addictive Disorders, VA Medical Center, 116A-H, 7180 Highland Drive, Pittsburgh, PA 15206, USA.
J Addict Dis. 2004;23(1):65-75. doi: 10.1300/J069v23n01_06.
Rapid Opioid Detoxification (ROD), using a combination of the long acting opioid antagonist, Naltrexone and the alpha 2 agonist Clonidine, is a method to detoxify patients who are opioid dependent. The daily administration of Naltrexone in increasing dosages decreases the duration of the withdrawal syndrome associated with opioids, especially longer acting drugs such as Methadone. This study is intended to report the frequency of delirium, as defined in DSM IV, during the ROD of Methadone maintained patients. A chart review was conducted of twenty consecutive patients who received in-patient ROD from Methadone maintenance from January 1999 to December 1999. Methadone was tapered and discontinued prior to ROD and Naltrexone was administered in increasing daily doses. Five individuals developed delirium and discontinued the procedure on the first day, fourteen patients completed the protocol, and one dropped out prior to completion. A significant incidence of delirium resulted from the ROD procedure.
快速阿片类药物脱毒（ROD）是一种用于帮助阿片类药物依赖患者脱毒的方法，它联合使用长效阿片类拮抗剂纳曲酮和α2激动剂可乐定。每日递增剂量服用纳曲酮可缩短与阿片类药物相关的戒断综合征持续时间，尤其是对于作用时间较长的药物，如美沙酮。本研究旨在报告在美沙酮维持治疗患者的快速阿片类药物脱毒过程中，按照《精神疾病诊断与统计手册》第四版（DSM IV）定义的谵妄发生率。对1999年1月至1999年12月期间连续20例接受住院美沙酮维持治疗患者进行快速阿片类药物脱毒的病历进行了回顾。在快速阿片类药物脱毒前逐渐减少并停用美沙酮，每日递增剂量服用纳曲酮。5例患者出现谵妄并在第一天中断了该程序，14例患者完成了方案，1例在完成前退出。快速阿片类药物脱毒程序导致了显著的谵妄发生率。
