Methods of Detoxification and Their Role in Treating Patients With Opioid Dependence

Opioid dependence and its associated morbidity, mortality, and social costs continue to plague societies around the world. Opioid dependence is characterized by physical dependence as evidenced by tolerance and withdrawal and by behavioral problems, including the inability to control opioid use, opioid use despite adverse consequences, and social dysfunction. The 2003 National Survey on Drug Use and Health reported that 3.7 million Americans had used heroin at some time in their lives.¹ The Monitoring the Future Survey noted that approximately 1.2% of 10th- and 12th-graders reported ever using heroin in 2004.² In addition, the recent trend of increasing abuse of prescription opioids including oxycodone, propoxyphene, hydrocodone, hydromorphone, and meperidine has been a major concern since the late 1990s. The National Survey on Drug Use and Health¹ estimated that as of 2003, more than 31.2 million Americans had used narcotic pain relievers in a “nonmedicinal” manner sometime in their lives and 11.7 million were “past year” nonmedicinal users in 2003.¹ The Monitoring the Future Survey indicated that 6.2% of 10th-graders and 9.3% of 12th-graders used hydrocodone and 3.5% of 10th-graders and 5.0% of 12th-graders used oxycodone in 2004.² These statistics and the overall lack of access to high-quality treatment resources for opioid-dependent individuals³ point directly to the urgent need to develop new treatment strategies for opioid dependence while expanding access to established treatment approaches known to be effective.