TY - JOUR
KW - Adult
KW - Amines/therapeutic use
KW - Analgesics, Opioid/adverse effects
KW - Buprenorphine/therapeutic use
KW - Clonidine/analogs & derivatives/therapeutic use
KW - Counseling
KW - Cyclohexanecarboxylic Acids/therapeutic use
KW - Female
KW - Humans
KW - Hydroxyzine/therapeutic use
KW - Male
KW - Naltrexone/therapeutic use
KW - Narcotic Antagonists/therapeutic use
KW - Opiate Substitution Treatment/methods
KW - Opioid-Related Disorders/drug therapy/psychology/therapy
KW - Retrospective Studies
KW - Substance Withdrawal Syndrome/drug therapy/psychology/therapy
KW - Treatment Outcome
KW - Young Adult
KW - gamma-Aminobutyric Acid/therapeutic use
KW - opioid withdrawal
KW - antagonist therapy
KW - medically supervised opioid withdrawal
KW - Naltrexone
AU - G. Rudolf
AU - J. Walsh
AU - A. Plawman
AU - P. Gianutsos
AU - W. Alto
AU - L. Mancl
AU - V. Rudolf
A1 - 
AB - BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin. Subjects also received ancillary medications as needed, and routine counseling. Primary outcomes were completion of medically supervised withdrawal, and initiation of injectable extended release (ER) naltrexone treatment. Secondary outcomes included the length of hospital stay, Clinical Opiate Withdrawal Scale (COWS) scores, and facilitation to substance use disorder treatment intervention. Ancillary medication use and adverse effects were also assessed. RESULTS: A total of 79 (94%) of subjects completed medically supervised withdrawal. A total of 27 (32%) subjects chose to pursue transition to ER naltrexone, and 24 of the 27 (89%) successfully received the injection prior to hospital discharge. The protocol subjects had a mean length of hospital stay of 3.6 days, and the mean COWS scores was 3.3, 3.4, 2.8, and 2.4 on Day 1, 2, 3, and 4, respectively. Furthermore, 71 (85%) engaged in an inpatient or outpatient substance use disorder (SUD) treatment program following protocol completion. CONCLUSION: This retrospective chart review suggests the feasibility of a novel protocol for medically supervised opioid withdrawal and transition to relapse prevention strategies, including injectable ER naltrexone. This withdrawal protocol does not utilize opioid agonists or other controlled substances..
AD - a Department of Pain Services , Swedish Medical Center , Seattle , WA , USA.; b Addiction Recovery Service, Swedish Medical Center , Seattle , WA , USA.; b Addiction Recovery Service, Swedish Medical Center , Seattle , WA , USA.; c Department of Family Medicine , Swedish Medical Center Cherry Hill Campus , Seattle , WA , USA.; c Department of Family Medicine , Swedish Medical Center Cherry Hill Campus , Seattle , WA , USA.; d Department of Biostatistics , University of Washington , Seattle , WA , USA.; b Addiction Recovery Service, Swedish Medical Center , Seattle , WA , USA.
BT - The American Journal of Drug and Alcohol Abuse
C5 - Opioids & Substance Use
CP - 3
CY - England
DO - 10.1080/00952990.2017.1334209
IS - 3
JF - The American Journal of Drug and Alcohol Abuse
M1 - Journal Article
N2 - BACKGROUND: The clinical feasibility of a novel non-opioid and benzodiazepine-free protocol was assessed for the treatment of medically supervised opioid withdrawal and transition to subsequent relapse prevention strategies. METHODS: A retrospective chart review of DSM-IV diagnosed opioid-dependent patients admitted for inpatient medically supervised withdrawal examined 84 subjects (52 males, 32 females) treated with a 4-day protocol of scheduled tizanidine, hydroxyzine, and gabapentin. Subjects also received ancillary medications as needed, and routine counseling. Primary outcomes were completion of medically supervised withdrawal, and initiation of injectable extended release (ER) naltrexone treatment. Secondary outcomes included the length of hospital stay, Clinical Opiate Withdrawal Scale (COWS) scores, and facilitation to substance use disorder treatment intervention. Ancillary medication use and adverse effects were also assessed. RESULTS: A total of 79 (94%) of subjects completed medically supervised withdrawal. A total of 27 (32%) subjects chose to pursue transition to ER naltrexone, and 24 of the 27 (89%) successfully received the injection prior to hospital discharge. The protocol subjects had a mean length of hospital stay of 3.6 days, and the mean COWS scores was 3.3, 3.4, 2.8, and 2.4 on Day 1, 2, 3, and 4, respectively. Furthermore, 71 (85%) engaged in an inpatient or outpatient substance use disorder (SUD) treatment program following protocol completion. CONCLUSION: This retrospective chart review suggests the feasibility of a novel protocol for medically supervised opioid withdrawal and transition to relapse prevention strategies, including injectable ER naltrexone. This withdrawal protocol does not utilize opioid agonists or other controlled substances..
PP - England
PY - 2018
SN - 1097-9891; 0095-2990
SP - 302
EP - 309
EP - 
T1 - A novel non-opioid protocol for medically supervised opioid withdrawal and transition to antagonist treatment
T2 - The American Journal of Drug and Alcohol Abuse
TI - A novel non-opioid protocol for medically supervised opioid withdrawal and transition to antagonist treatment
U1 - Opioids & Substance Use
U2 - 28795846
U3 - 10.1080/00952990.2017.1334209
VL - 44
VO - 1097-9891; 0095-2990
Y1 - 2018
ER -