TY - JOUR
KW - Adrenergic alpha-2 Receptor Agonists/administration & dosage/therapeutic use
KW - Buprenorphine/therapeutic use
KW - Clinical Protocols
KW - Clonidine/administration & dosage/therapeutic use
KW - Drug Administration Schedule
KW - Drug Therapy, Combination
KW - Humans
KW - Methadone/therapeutic use
KW - Naltrexone/administration & dosage/therapeutic use
KW - Narcotic Antagonists/administration & dosage/therapeutic use
KW - Narcotics/therapeutic use
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/drug therapy
KW - Substance Withdrawal Syndrome/drug therapy/prevention & control
AU - S. C. Sigmon
AU - A. Bisaga
AU - E. V. Nunes
AU - P. G. O'Connor
AU - T. Kosten
AU - G. Woody
A1 - 
AB - BACKGROUND: Opioid dependence is a significant public health problem associated with high risk for relapse if treatment is not ongoing. While maintenance on opioid agonists (i.e., methadone, buprenorphine) often produces favorable outcomes, detoxification followed by treatment with the mu-opioid receptor antagonist naltrexone may offer a potentially useful alternative to agonist maintenance for some patients. METHOD: Treatment approaches for making this transition are described here based on a literature review and solicitation of opinions from several expert clinicians and scientists regarding patient selection, level of care, and detoxification strategies. CONCLUSION: Among the current detoxification regimens, the available clinical and scientific data suggest that the best approach may be using an initial 2-4 mg dose of buprenorphine combined with clonidine, other ancillary medications, and progressively increasing doses of oral naltrexone over 3-5 days up to the target dose of naltrexone. However, more research is needed to empirically validate the best approach for making this transition.
BT - The American Journal of Drug and Alcohol Abuse
C5 - Opioids & Substance Use
CP - 3
CY - England
DO - 10.3109/00952990.2011.653426
IS - 3
JF - The American Journal of Drug and Alcohol Abuse
N2 - BACKGROUND: Opioid dependence is a significant public health problem associated with high risk for relapse if treatment is not ongoing. While maintenance on opioid agonists (i.e., methadone, buprenorphine) often produces favorable outcomes, detoxification followed by treatment with the mu-opioid receptor antagonist naltrexone may offer a potentially useful alternative to agonist maintenance for some patients. METHOD: Treatment approaches for making this transition are described here based on a literature review and solicitation of opinions from several expert clinicians and scientists regarding patient selection, level of care, and detoxification strategies. CONCLUSION: Among the current detoxification regimens, the available clinical and scientific data suggest that the best approach may be using an initial 2-4 mg dose of buprenorphine combined with clonidine, other ancillary medications, and progressively increasing doses of oral naltrexone over 3-5 days up to the target dose of naltrexone. However, more research is needed to empirically validate the best approach for making this transition.
PP - England
PY - 2012
SN - 1097-9891; 0095-2990
SP - 187
EP - 199
EP - 
T1 - Opioid detoxification and naltrexone induction strategies: Recommendations for clinical practice
T2 - The American Journal of Drug and Alcohol Abuse
TI - Opioid detoxification and naltrexone induction strategies: Recommendations for clinical practice
U1 - Opioids & Substance Use
U2 - 22404717
U3 - 10.3109/00952990.2011.653426
VL - 38
VO - 1097-9891; 0095-2990
Y1 - 2012
ER -