Glasper Anthony, Gossop Michael, de Wet Cornelis, Reed Laurence, Bearn Jennifer
National Addiction Centre, London, UK.
Pharmacology. 2008;81(2):92-6. doi: 10.1159/000109982. Epub 2007 Oct 19.
This study investigates factors influencing the severity of opiate withdrawal symptoms, focusing on the relationship between methadone dose and withdrawal severity among opiate-dependent in-patients receiving methadone detoxification.
The sample comprised 48 opiate-dependent patients admitted to a specialist in-patient drug treatment service and withdrawn from opiates, using a 10-day methadone reduction schedule. The severity of withdrawal symptoms was assessed daily using the Short Opiate Withdrawal Scale.
Patients withdrawn from higher doses of methadone and those reporting higher levels of anxiety reported more severe withdrawal symptoms. No relationship was found between methadone dose and completion of detoxification or length of hospital stay.
Although patients on higher doses of methadone reported more severe opiate withdrawal symptoms than patients on lower doses, the dose effect accounted for only a small percentage of the total variance. Nonetheless, the finding of a dose-response effect supports one of the basic principles of clinical practice during detoxification, namely the matching of the medication withdrawal schedule to the pre-admission opiate dose.
本研究调查影响阿片类药物戒断症状严重程度的因素,重点关注接受美沙酮脱毒治疗的阿片类药物依赖住院患者中美沙酮剂量与戒断严重程度之间的关系。
样本包括48名入住专科住院药物治疗服务机构且已停用阿片类药物的阿片类药物依赖患者,采用10天美沙酮递减方案。使用简短阿片类药物戒断量表每日评估戒断症状的严重程度。
从较高剂量美沙酮停药的患者以及报告焦虑水平较高的患者,其戒断症状更严重。未发现美沙酮剂量与脱毒完成情况或住院时间之间存在关联。
尽管服用较高剂量美沙酮的患者比服用较低剂量美沙酮的患者报告有更严重的阿片类药物戒断症状,但剂量效应仅占总变异的一小部分。尽管如此,剂量反应效应的发现支持了脱毒期间临床实践的基本原则之一,即药物撤药方案与入院前阿片类药物剂量相匹配。