Effect of medical detoxification duration on withdrawal, dependency and abstinence in opioid dependent patients

Chemical dependency is a public health crisis that has reached epidemic proportions, causing catastrophic destruction of individual, community health and societal stability. The misuse and dependency of opioid drugs in the form of heroin and prescription analgesics have particularly increased, to become the fastest growing chemical addiction in the past decade. Respectively, the demand for treatment of opioid dependency disorders has also increased. The goal of the study is to investigate the effectiveness of three different detoxification regimens of short (7day), moderate (14 day), and long term (21 day) that are commonly used for the treatment of opioid related withdrawal syndromes. More specifically, the goal is to test the hypothesis that improvement in opioid withdrawal syndromes and opioid abstinence will be greater for those in the moderate duration detoxification regimen, than in the short or long programs.; To assess the association between opioid detoxification and duration of treatment, this study was a secondary data analysis of patients exposed to three different detoxification treatment regimens of short (7 day), moderate (14 day), and long-term (21 day). The design used in this study consisted of a stratified random sample of the medical records of 156 opioid dependent patients who were treated at the North Shore Outpatient Detoxification Program (NSODP) located in Long Island, New York between January 15, 2003 and June 15, 2005.; The outcomes measured were opioid withdrawal syndromes and abstinence as measured by the Clinical Opiate Withdrawal Scale (COWS), Subjective Opioid Withdrawal Scale (SOWS), and urine toxicology. Opioid withdrawal syndromes improved substantially more in the moderate detoxification regimen as compared to the short and long-term regimens even after adjusting for COWS and SOWS scores at intake and for other variables (beta=.663, p<.001 for COWS, beta=.426, p<.001 for SOWS). Urine toxicology as measured by logistic regression indicated that the moderate regimen had greater improvement in opioid positive urines as compared to the short or long regimens even when other predictors were added (OR=0.08, 95%CI 0.03-0.23). Analyses in subgroups based on intake scores and urine toxicology revealed consistent results. Clearly, detoxification duration is a factor influencing the control of withdrawal syndromes. Moderate duration of 14 days appears to be more effective as compared to a short or long regimen in the control of withdrawal syndromes regardless of co-morbid conditions, demographic, or drug use factors. A limitation of this study is the differences in the intake scores between the three detoxification regimens. Based on the results of study, and existing research, it is theorized that the moderate detoxification regimen will show the best improvements in terms of withdrawal and abstinence as compared to short or long regimens.