The Comparison of Stress Response to Rapid Opioid Detoxification Applying Different Methods of Opioid Antagonism
Opiate Addiction
About this trial
This is an interventional treatment trial for Opiate Addiction focused on measuring Opioid detoxification, Opioid antagonist induction, Conscious sedation
Eligibility Criteria
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
Sites / Locations
- Republic Vilnius University Hospital
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Intervention
Control
Opioid antagonist induction. Day 4. Duration 12-16 hours. Naltrexone gradual increase from 50 µg p/o to a total dose of 12,5 mg according to a predefined protocol: st hour 50 µg nd hour 50 µg rd hour 100 µg th hour 100 µg th hour 200 µg th hour 400 µg th hour 800 µg th hour 1600 µg th hour 3200 µg th hour 6000 µg Correction of symptoms for opioid abstinence: Clonidine 150 µg p/o every 4 hours (Day 3 and Day 4) Lorazepam 5 mg p/o every 4 hours (Day 3 and Day 4), Lorazepam 2,5 mg po every 4 hours (Day 5, Day 6)
Opioid antagonist induction. Day 4. Duration 12-16 hours. Naltrexone single dose 12,5 mg p/o Correction of symptoms for opioid abstinence: Clonidine 150 µg p/o every 4 hours (Day 3 and Day 4) Lorazepam 5 mg p/o every 4 hours (Day 3 and Day 4), Lorazepam 2,5 mg po every 4 hours (Day 5, Day 6)