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February 5, 1997

Experts Debate Merits of 1-Day Opiate Detoxification Under Anesthesia

JAMA. 1997;277(5):363-364. doi:10.1001/jama.1997.03540290015006

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AT 7 AM on a Monday morning last fall, a 41-year-old Philadelphia man arrived at a private clinic in a nearby New Jersey town for a controversial treatment that he hoped would help him uproot a 20-year-old opiate addiction.

Previous attempts to kick his narcotic habit had been unsuccessful because the misery of withdrawal-related symptoms and ceaseless drug craving posed insurmountable obstacles, he said. But what drew him and hundreds of others to the Merchantville, NJ, clinic was the allure of what some centers have touted as virtually painless opiate detoxification achieved in hours rather than days or weeks.

The basic approach, which builds on studies carried out during the past 2 decades, involves administering an opiate antagonist such as naloxone hydrochloride or naltrexone hydrochloride to displace heroin or other narcotics from a patient's opiate receptors. Various combinations of other drugs, such as clonidine hydrochloride, ondansetron hydrochloride, and somatostatin, are