Cochrane

Review question We reviewed the evidence on the effects of opioid antagonists (naltrexone, naloxone) plus minimal sedation for managing withdrawal in people who are dependent on opioid drugs (for example, heroin or pharmaceutical opiates). Background Managed withdrawal, or detoxification, is a required first step for longer-term treatments of opioid ...

Review question We reviewed the evidence about the effectiveness of supervised dosing strategies in opioid substitution treatment for people dependent on opioid drugs. Background Opioid dependence (OD) is a global clinical and public health problem that is associated with significant burden of disease and drug-related deaths. OD represents a complex ...

Review question We reviewed the evidence about the effect of buprenorphine for managing withdrawal in people who are dependent on opioid drugs (for example, heroin or pharmaceutical opiates). Background Managed withdrawal, or detoxification, is a required first step for long-term treatment of opioid dependence. The combination of uncomfortable symptoms ...

Background Use of pharmaceutical opioids (medicines that are used to treat pain) has increased dramatically in some parts of the world since the mid-1990s. With the increased use, there has been increasing numbers of people seeking treatment for dependence (addiction) on pharmaceutical opioids. Currently, most treatment guidelines are based on research ...

Review question We reviewed the evidence about the effect of alpha2-adrenergic agonists (clonidine, lofexidine, guanfacine, and tizanidine) in managing withdrawal in people who are dependent on opioid drugs (for example heroin, methadone). Background Managed withdrawal, or detoxification, is a required first step for longer-term treatments of opioid ...

Review question We reviewed the evidence about the effect of maintenance treatment either alone or associated with psychosocial intervention compared with no intervention, placebo, other pharmacological intervention, pharmacological detoxification or psychosocial intervention in adolescents (13 to 18 years). Background Substance abuse among adolescents ...

Detoxification treatment for heroin dependents adolescents Review question We reviewed the evidence on the effect of detoxification treatment compared with pharmacological maintenance treatment or psychosocial intervention in achieving abstinence on adolescents heroin dependents. Background Substance abuse among adolescents (13 to 18 years old) ...

Background Methadone is widely used as a replacement for illicit opioid use such as heroin in medically-supported opioid substitution maintenance programmes. Two other drugs have been used to help reduce illicit opioid use, specifically buprenorphine and LAAM (levo-alpha-acetylmethadol). LAAM is not used in current clinical practice. Buprenorphine ...

Some women continue to use opiates when they are pregnant, yet heroin readily crosses the placenta. Opiate-dependent women experience a six-fold increase in maternal obstetric complications and give birth to low-weight babies. The newborn may experience narcotic withdrawal (neonatal abstinence syndrome) and have development problems. There is also increased ...

No evidence has been found to support the use of the electrocardiogram (ECG) for preventing cardiac arrhythmias in methadone-treated opioid dependents. A maintenance program with methadone is an effective treatment for people who are dependent on opioids, in terms of increased retention in treatment, reduced use of opioids, reduced human immunodeficiency ...