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February 22, 2006

Heroin Detoxification—Reply

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2006;295(8):885-886. doi:10.1001/jama.295.8.886-a

In Reply: The study by Dr Favrat and colleagues1 comparing anesthesia-assisted rapid opioid detoxification with a clonidine-based inpatient alternative had results similar to ours. As Drs Favrat and Besson noted, 3 randomized clinical trials have now failed to find evidence to support long-term efficacy for the anesthesia-assisted procedure, and none has demonstrated evidence supporting its use. In our study, the positive control procedure, buprenorphine-assisted rapid opioid detoxification, was comparable with the anesthesia procedure on all important positive outcome measures (withdrawal scores, rates of naltrexone induction, and treatment retention) while being much safer and far less expensive.

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