Opiate Withdrawal Symptoms in Response to 10-Day and 21-Day Methadone Withdrawal Programmes

1989 ◽  
Vol 154 (3) ◽  
pp. 360-363 ◽  
Author(s):  
Michael Gossop ◽  
Paul Griffiths ◽  
Brendan Bradley ◽  
John Strang

This study investigates and compares the responses of 132 opiate addicts to a 10-day or a 21-day in-patient oral methadone withdrawal regime. For both groups, symptom severity (on the Opiate Withdrawal Scale) steadily increased through the methadone withdrawal phase, and peaked near the point of completion of the prescribed drug, declining slowly thereafter. Patients on the 10-day programme reported significantly higher peak withdrawal scores than those on the 21-day programme. Although the proportions who completed detoxification were similar, there was a significantly higher drop-out rate immediately after detoxification for the 10-day group. The possible benefits and handicaps of the two withdrawal schedules are considered and recommendations are proposed for further refinement of the present widely adopted approach.

1984 ◽  
Vol 144 (2) ◽  
pp. 203-208 ◽  
Author(s):  
Michael Gossop ◽  
Brendan Bradley ◽  
Philip Connell ◽  
John Strang

Summary A group of 24 opiate addicts admitted to an in-patient drug dependence unit received either electrostimulation or graduated oral methadone withdrawal. Addicts treated with electrostimulation showed high levels of withdrawal symptoms during the first week of treatment: these reached a peak on Day 3. In this respect electrostimulation was markedly inferior to methadone withdrawal treatment. However, although progressive methadone withdrawal quickly reduced symptoms to a moderate or low level, there was no reduction in symptomatology as late as one month after admission (i.e. after ten days without methadone). The implications of these findings are discussed.


1990 ◽  
Vol 157 (5) ◽  
pp. 748-752 ◽  
Author(s):  
N. Loimer ◽  
R. Schmid ◽  
K. Lenz ◽  
O. Presslich ◽  
J. Grünberger

In a double-blind placebo-controlled trial of 18 patients, methohexitone blocked objective signs of opiate withdrawal caused by a bolus injection of naloxone. Furthermore, in continuing the naloxone therapy for 48 hours, no withdrawal signs appeared. Levels of withdrawal distress returned to normal levels within six days. This approach can be regarded as an effective and well tolerated withdrawal therapy with low drop-out rates.


1986 ◽  
Vol 149 (2) ◽  
pp. 235-238 ◽  
Author(s):  
Grania T. Phillips ◽  
Michael Gossop ◽  
Brendan Bradley

Psychological and drug-related variables and their effect on the severity of withdrawal symptoms were examined in a group of addicts being withdrawn from opiates on an in-patient drug dependence unit. Two psychological factors—neuroticism and the degree of distress expected by the patient—were related to subsequent severity of symptoms. Both are anxiety-related, and may serve to amplify withdrawal symptoms. Surprisingly, drug dose was unrelated to symptom severity.


2015 ◽  
Vol 63 (2) ◽  
pp. 117-124 ◽  
Author(s):  
Max Böckermann ◽  
Annika Gieselmann ◽  
Marjolijn Sorbi ◽  
Reinhard Pietrowsky
Keyword(s):  
Drop Out ◽  

Hintergrund: Dieser Artikel beschreibt die Entwicklung eines internetbasierten begleiteten Selbsthilfetrainings (Albtraumcoach) zur Bewältigung von Albträumen, das innerhalb zweier Pilotstudien auf seine Durchführbarkeit und Anwendbarkeit getestet wurde. Methoden: Innerhalb eines neunstufigen Modells wird die Entwicklung der Intervention beschrieben. Dabei wird neben der wissenschaftlichen Evidenz, die die Basis für die Intervention bildet, auf technische, ethische, datenschutzrechtliche und weitere spezifische Maßnahmen innerhalb der Interventionsentwicklung eingegangen. In zwei Pilotstudien evaluierten zudem 10 Personen mit schlechten Träumen in der Vergangenheit die Durchführbarkeit (Studie 1) und 12 Personen mit wiederkehrenden Albträumen die Anwendbarkeit sowie den Nutzen der Intervention (Studie 2). Abhängige Variablen waren die Qualität der einzelnen Sitzungen, die Zufriedenheit mit der Intervention sowie Albtraumfrequenz, Albtraumbelastung, Schlafqualität und Depressivität. Ergebnisse und Diskussion: Die Durchführbarkeit und Anwendbarkeit des Trainings wurden positiv beurteilt. Während die Drop-out-Rate verhältnismäßig hoch war, ergaben sich erste, zurückhaltend zu beurteilende, Hinweise für einen Nutzen der Intervention.


Author(s):  
Stephanie Kunz ◽  
Michael Schulz ◽  
Gabriele Syrbe ◽  
Martin Driessen

<B>Fragestellung:</B> Lässt die wissenschaftliche Datenlage positive Behandlungseffekte durch Ohrakupunktur in der Entzugsbehandlung von Alkohol- und Opiatabhängigen erwarten? </P><P> <B>Methodik:</B> Die im Rahmen der Recherche gefundenen Studien bezogen sich auf den Entzug von Alkohol (sechs) und von Kokain und Opiaten (acht). Die Studien wurden auf ihre methodische Qualität hin überprüft. </P><P> <B>Ergebnisse:</B> Es konnten 14 randomisierte kontrollierte Studien (RCT) zu Ohrakupunktur in der Behandlung von Alkohol- und Opiatabhängigkeit identifiziert werden. Dabei weisen die meisten Studien methodische Mängel auf. Ein Vergleich der Studien ist aufgrund unterschiedlicher Paradigmen kaum möglich, die Drop Out Rate liegt häufig über 20%. </P><P> <B>Schlussfolgerung:</B> Insgesamt reicht die verfügbare wissenschaftliche Datenlage nicht aus, um eine positive Wirkung der Akupunktur bei substanzbezogenen Störungen als gesichert anzunehmen.


2020 ◽  
Vol 67 (6) ◽  
pp. 712-722
Author(s):  
Sebastian Gmeinwieser ◽  
Kai Sebastian Schneider ◽  
Maximilian Bardo ◽  
Timo Brockmeyer ◽  
York Hagmayer

2012 ◽  
Vol 21 (5-6) ◽  
pp. 145-172
Author(s):  
Yair Galily ◽  
Orly Kayam ◽  
Michael Bar-Eli

Abstract Human resources are the most crucial element in the selection of suitable fitness instruction trainers (FIT) and the results of the screening process impact greatly on the entire physical training system in the Israeli army, both in the short-term and the long-term (potential officers, young officers and developing and veteran officers). The aim of the current study is to examine the effectiveness, validity and reliability of the screening process for acceptance to the female fitness instructors training course in the Israel Defense Forces (IDF). The screening process aims to identify those that are most suitable from a large pool of candidates, in order to ensure the highest possible level of candidates and the lowest possible drop-out rate from the training course and subsequent army service. The paper examines the reliability of the classification exam currently administered in the course and its validity in predicting those candidates who will succeed in the course and in their assignments afterwards. The sample is based on a data analysis of nine screening dates over three years (three each year). The evaluation of validity is based on the relationship between the course entrance exam grades (administered a year before enlistment), exam grades at the beginning of the course and additional data relating to success in the field.


2021 ◽  
pp. 1-19
Author(s):  
Nina Lindblom ◽  
Lars Lindquist ◽  
Jacob Westman ◽  
Mikael Åström ◽  
Roger Bullock ◽  
...  

Background: Accumulating data suggest infectious agents are involved in Alzheimer’s disease (AD). The two primary aims of this trial were to assess safety and efficacy of an antiviral drug combination on AD progression. Objective: The trial evaluated whether Apovir, a combination of two antiviral agents, pleconaril (active on enteroviruses) and ribavirin (active on several viruses), could slow AD progression. Methods: Sixty-nine patients 60–85 years were treated with Apovir or placebo for 9 months and followed until 12 months after end of treatment. Cognitive tests, safety, biomarkers, drug plasma, and cerebrospinal fluid concentrations were assessed. Results: The tolerability of Apovir was compromised as demonstrated by the large drop-out rate and increased frequency and severity of adverse events. The primary endpoint, demonstrating a difference in change from baseline to 9 months between groups in ADAS-cog total score, was not met (p = 0.1809). However, there were observations indicating potential effects on both ADAS-cog and CDR-SB but these effects need to be verified. Also, there was a decrease in cerebrospinal fluid amyloid-β in Apovir at 9 months (p = 0.0330) but no change in placebo. Conclusion: This was the first randomized, placebo controlled clinical trial exploring antiviral treatment on AD progression. The trial is considered inconclusive due to the large drop-out rate. New trials are needed to verify if the indications of effect observed can be confirmed and which component(s) in Apovir contributed to such effects. Pleconaril alone may be studied to improve the tolerability and to verify if enterovirus is involved in the disease process.


2014 ◽  
Vol 42 (6) ◽  
pp. 747-759 ◽  
Author(s):  
Stella W. Y. Chan ◽  
Malcolm Adams

Background: The IAPT services provide high and low intensity psychological treatments for adults suffering from depression and anxiety disorders using a stepped care model. The latest national evaluation study reported an average recovery rate of 42%. However, this figure varied widely between services, with better outcomes associated with higher “step-up” rates between low and high intensity treatments. Aims: This study aimed to compare the two intensity groups in an IAPT service in Suffolk. Method: This study adopted a between groups design. A sample of 100 service users was randomly selected from the data collected from an IAPT service in Suffolk between May 2008 and February 2011. The treatment outcomes, drop-out rate, and other characteristics were compared between those who received high and low intensity treatments. Results: The high intensity group received, on average, more sessions and contact time. They received more CBT sessions and less guided self-help. There were no group differences in terms of the drop-out and appointment cancellation rates. Analyses on clinical outcomes suggested no group difference but demonstrated an overall recovery rate of 52.6% and significant reduction in both depression and anxiety symptoms. Conclusions: Despite methodological limitations, this study concludes that the service as a whole achieved above-average clinical outcomes. Further research building upon the current study in unpacking the relative strengths and weaknesses for the high and low intensity treatments would be beneficial for service delivery.


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