The Comparison of Stress Response to Rapid Opioid Detoxification Applying Different Methods of Opioid Antagonism

Study enrolls opiate addicted patients who are motivated for a long term treatment and full opiate abstinence. Patient is offered to take part in a study. Information is provided regarding protocol, aim and course of study. Patients who are eligible and consent for study commit to follow the pre-study recommendations.

Study consists of:

Primary assessment - information about study. Assessment of patient according to predefined criteria. Consent form. Allocation of the treatment date.

Stabilization - Buprenorphine. Assessment according to SOWS and OWS. Total amount of buprenorphine is recorded.

Repeated evaluation - patient after successful stabilization course undergoes urine test for psychotropic substances, blood alcohol level is recorded. If any test is positive patient is not enrolled to study.

Correction of opioid withdrawal symptoms - all of the patients receive medicines for opioid detoxification, infusion therapy in predefined doses.

Antagonist induction - patients receive opioid antagonist (incremental or standard dose). Withdrawal symptoms are assessed and correction with lorazepam is given if needed.

Data collection - data is recorded (demographic, epidemiological, vital signs, opioid withdrawal symptoms, levels of hormones, metabolites, electrolytes).

Inclusion criteria

• Opiate addiction
• Use of short-acting opiate (morphine or heroine)
• Age > 18 years
• Length of opiate addiction > 1 year
• Patient can make a decision for detoxification and has a capacity to consent for procedure
• Written consent for procedure

Exclusion criteria

• Polyvalent addiction
• Pregnancy or breast feeding
• Cardiovascular pathology
• Acute or chronic kidney disease
• Decompensated liver pathology (jaundice, ascites, hepatic encephalopathy)
• Infective complications of opiate addiction (pneumonia, phlegmon, abscess, thombophlebitis, sepsis)
• Malnutrition (Nutritional risk screening 2002 score ≥3)
• Diabetes mellitus
• Previous history of psychosis
• Glasgow coma scale < 15
• Abdominal surgical intervention during last 30 days
• Cumulative buprenorphine dose for stabilization < 8 mg
• Positive test for psychoactive substances during treatment
• Refusal to participate in study at any point of it