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Opioid detoxification done in following manner

  1. No drugs (Therapeutic Community)
    The patient are closed in a setting no drugs are given and was given responsibility like cleaning, shopping, cooking etc. The person experiences the withdrawal.
    (The person has erect hairs (piloerection) giving appearance of spinous animal “Cold turkey” so it is also called as “cold turkey” method of treatment.
  2. Symptomatic drugs give drugs according to withdrawal symptoms.
    - For ache & pain - NSAIDS
    - For Diarrhoea  - Loperamide
    - For Insomnia   - Benzodiazepines
    - For Other   - Clonidine to Decrease sympathetic overactivity.
  3. Substitution drugs - substitute the opioid with other long acting opioids like.
    1. Proxyvon - Dextro propoxy phene
    2. Methadone
    3. Buprenorphine.
Relapse prevention - done with opioid antagonist.
- Naltrexone is chosen because of the longer half life t½ . - 96 hrs.
- Naloxone is used in overdose or toxicity of opioid, t½ - ½ hr.
Maintenance treatment done for people for whom drug free lifestyle is not possible. In America and worldwide done with Methadone Maintenance Clinics.
In India Buprenorphine is used for Maintenance therapy  called as OST - Opioid Substitution Treatment

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