Detoxification

Description: 
A reference tool used to provide clinicians with stabilization resources for substance use disorder within active duty and veteran populations, including resources on pharmacological treatment and substance titration.
Source: 
VA/DoD Clinical Practice Guideline for the Management of Substance Use Disorders
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Detoxification, or medically supervised withdrawal (MSW), involves using a medication to take a patient from an opioid-dependent to an opioid-free state. Patients who want to stop using opioids but not want to be maintained on buprenorphine may request MSW. Conducting MSW involves inducting the patient onto buprenorphine following the standard induction protocol and then tapering the patient back off of buprenorphine. The buprenorphine/naloxone combination formulation should be used in most cases.

Risks of MSW

Description: 
This newsletter article from NAABT.org lists and describes 15 ways patients can save money on buprenorphine treatment.
Source: 
The National Alliance of Advocates for Buprenorphine Treatment (NAABT)
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Patient Handouts: 
Description: 
This article provides guidance on the treatment of alcohol and drug abuse, and discusses various treatment plans.
Source: 
National Institute on Drug Abuse (NIDA)
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Withdrawal Versus Precipitated Withdrawal

Description: 
Two types of withdrawal are associated with mu opioid agonist dependence: withdrawal and precipitated withdrawal.

Habitual opioid users become dependent on opioids. Dependent individuals who stop or decrease opioid use may go into spontaneous withdrawal. Dependent individuals who take an opioid antagonist (or partial agonist, in some cases) may go into precipitated withdrawal.

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Physician stage in practice: 
Description: 
This journal article compares the effectiveness of detoxification vs. continuing buprenorphine-naloxone therapy for treating opioid-addicted adolescents. The study followed 152 patients between the ages of 15 and 21 who were randomly selected to receive either a 12-week buprenorphone-naloxone program, or a 14-day taper.
Source: 
The Journal of the American Medical Association (JAMA)
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Description: 
This 2007 article study examined the quality of life of heroin-dependent patients being treated with methadone vs. heroin-dependent patients being treated with buprenorphine.
Source: 
American Journal of Drug and Alcohol Abuse
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Description: 
This 2003 study found that buprenorphine and methadone were equally as effective in heroin-dependent patients; however, treatment retention was lower for buprenrophine.
Source: 
Addiction
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