HTTP/1.0 200 OK Content-Type: text/html Heroin Detox Using Anesthesia Limited And Risky, Study Says
Pubdate: Wed, 24 Aug 2005
Source: Los Angeles Times (CA)
Section: Main News; National Desk; Part A; Pg. 15
Copyright: 2005 Los Angeles Times
Author: Alex Raksin, Times Staff Writer


Using general anesthesia to help detoxify heroin addicts is no more 
effective than other treatments and potentially much more dangerous, says a 
study to be published today by Columbia University researchers.

The method -- going by names such as "rapid detox" and "detox in a day" -- 
has been promoted as a quick and easy way to relieve the stress and pain of 
withdrawal from heroin as well as from more easily accessible opiates, such 
as Vicodin and OxyContin.

Dr. Eric D. Collins, an assistant professor of psychiatry at Columbia, 
studied 106 addicts, who were divided into three groups.

One group was put under general anesthesia for about five hours and given a 
high dose of naltrexone, a drug used to neutralize heroin's effects. 
Another was given a heroin substitute called buprenorphine and eased onto 
naltrexone. A third group was given the antihypertensive clonidine, which 
lessens withdrawal symptoms.

All patients were then offered 12 weeks of additional naltrexone therapy 
and psychotherapy designed to prevent a relapse into heroin use.

None of the methods was very successful.

The results showed high relapse rates, with 11% of the patients finishing 
treatment and providing no more than two heroin-positive urine samples.

Three patients who underwent general anesthesia nearly died.

One suffered a severe buildup of fluid in the lungs and pneumonia, and 
another developed dangerously high blood sugar levels. A third patient 
entered a bipolar mental state that required hospitalization. All of the 
incidents were related to the use of general anesthesia.

The benefits of the method "were limited to the few hours when patients 
were under general anesthesia, and they came with risks that should be 
intolerable," said Collins, lead author of the study, to be published in 
the Journal of the American Medical Assn.

Jake Epperly, clinical director of the Midwest Rapid Opiate Detox Center, 
which has clinics nationwide, disputed the study's findings, saying the 
Columbia physicians were inexperienced with using general anesthesia as a 
detoxification method.

"Our anesthesiologists have done 400 or 500 procedures on average," he 
said. "Experience is everything."

In an editorial accompanying the study, Dr. Patrick G. O'Connor, a 
professor at the Yale School of Medicine, said the low success rate with 
the three methods showed that the best therapy still was weaning patients 
through long-term use of a heroin substitute, such as methadone.

Such treatment is prohibited in many California counties, including Fresno, 
Kern and Sacramento, where maintenance is seen as another kind of drug 
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