Stine S M, Kosten T R
Department of Psychiatry, West Haven VA Hospital, Connecticut 06516.
J Clin Psychopharmacol. 1992 Jun;12(3):203-9.
During the last 10 years new approaches for rapid opioid detoxification have included drug combinations such as clonidine and naltrexone to speed and ease the transition from opioid agonist to antagonist maintenance. Other drug combinations include naloxone with midazolam or methohexitone for inpatients, but rapid outpatient methods are more desirable. Clonidine combined with naltrexone enables abrupt opioid withdrawal in 3-5 days in an outpatient/day setting. This approach can be further improved by transition to the partial agonist buprenorphine from either heroin or methadone followed by a 1 day detoxification using naltrexone precipitated withdrawal, ameliorated by clonidine.
在过去10年中，快速阿片类药物脱毒的新方法包括使用可乐定和纳曲酮等药物组合，以加速并缓解从阿片类激动剂维持治疗向拮抗剂维持治疗的过渡。其他药物组合包括用于住院患者的纳洛酮与咪达唑仑或美索比妥，但更理想的是快速门诊治疗方法。可乐定与纳曲酮联合使用可使门诊患者在3至5天内突然停用阿片类药物。从海洛因或美沙酮过渡到部分激动剂丁丙诺啡，然后使用纳曲酮诱发戒断反应并通过可乐定缓解，进行为期1天的脱毒治疗，可进一步改进这种方法。
