Scopolamine Detoxification Technique for Heroin Dependence: A Randomized Trial
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ORIGINAL RESEARCH ARTICLE
Scopolamine Detoxification Technique for Heroin Dependence: A Randomized Trial Sheng Liu • Longhui Li • Wenwen Shen • Xueyong Shen • Guodong Yang • Wenhua Zhou
Published online: 3 October 2013 Ó Springer International Publishing Switzerland 2013
Abstract Background Easing psychological symptoms associated with heroin use and heroin relapse are important goals in the treatment of heroin dependence. However, most detoxification methods are designed to decrease withdrawal-related discomfort and complications, but not to reduce the psychological effects of heroin addiction. Objective The objective of this study was to evaluate the efficacy of scopolamine detoxification technique (SDT) relative to standard methadone detoxification (MD) to treat heroin withdrawal and psychological symptoms associated with heroin use and relapse. Methods In this 10-week randomized, controlled trial, treatment-seeking heroin-dependent participants were enrolled consecutively from Ningbo Addiction Research and Treatment Center, Ningbo, China. Opioid dependence was confirmed by a naloxone challenge test. Participants were included if they met Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV)
Trial Registration: chictr.org Identifier: ChiCTR-TRC-09000490.
Electronic supplementary material The online version of this article (doi:10.1007/s40263-013-0111-9) contains supplementary material, which is available to authorized users. S. Liu (&) X. Shen Shanghai University of Traditional Chinese Medicine, 1200 Cailun Rd, Shanghai 200032, China e-mail: [email protected] L. Li W. Shen G. Yang W. Zhou (&) Ningbo Addiction Research and Treatment Center, School of Medicine, Ningbo University, 42 Xibei St., Ningbo 315010, China e-mail: [email protected]
criteria for opioid dependence, were without major comorbid psychiatric illness, and were not allergic to scopolamine and chlorpromazine. Participants (N = 91; 18–50 years) were admitted to inpatient beds for 15 days and randomly assigned to receive either SDT (N = 46) or MD (N = 45) prior to being discharged and undergoing 8 weeks of outpatient treatment. During the inpatient stay, all participants received methadone during days 1–3. Those in the MD group then underwent a 10-day gradual dose-reduction regimen. Those in the SDT group underwent an SDT, such that subjects were given scopolamine (0.03–0.05 mg/kg, intravenously) and chlorpromazine (0.6–1.0 mg/kg, intravenously) under light anesthesia for 4–6 h once per day on days 4–6 or 4–7, depending on the severity of opioid-withdrawal symptoms. Self-reported withdrawal symptoms were assessed each day during the in-patient treatment phase. Heroin craving (assessed using a visual analog scale), Beck Depression Inventory, SelfRating Anxiety Scale, and working memory and attention tests (assessed using the Digit-span test and d2 test) were measured before (day 0) and after detoxification (day 15). Retention was assessed during the inpatient phase and the outpatient phase. Urine tests for opio
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