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October 22, 1997

Opiate Detoxification Under Anesthesia-Reply

Author Affiliations

Medical News & Perspectives, JAMA

JAMA. 1997;278(16):1319. doi:10.1001/jama.1997.03550160039031

In Reply.  —Concerns about opiate detoxification under anesthesia, raised by the unpublished February 1996 report prepared by the National Institute on Drug Abuse (NIDA)1 in consultation with a number of prominent addiction medicine experts, included possible cardiovascular complications of intravenous naloxone. (As noted in my Medical News & Perspectives article, the report does not represent official NIDA policy, although the institute's position is that more research is needed to evaluate safety and efficacy of the technique.) Such complications have been documented in surgical patients and, in at least 1 report, in a patient undergoing opiate detoxification,2 and citation of these reports in my article does not "misrepresent the facts."The Medical News & Perspectives article also points out that both naloxone and naltrexone have been used to displace heroin or other narcotics from a patient's opiate receptors. A number of investigators have switched to naltrexone because they believe that it