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Alexander DeLuca, M.D. |
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References and Resources: Detoxification and Patient Engagement Compiled by Alexander DeLuca: 1998 - 2006. New documents added on: 2006-03-21 - New! |
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New! Flawed Basis for FDA Safety Decisions: Anti-Depressants and Children Donald F Klein; Neuropsychopharmacology; 31(4):689-699; 2006 -- "The data necessary for objective evaluations of post-marketing harm cannot be gathered by the current process. Proper prospective surveillance by linked computerized medical records is a crucial issue that deserves major public and political attention and prompt action." See also: FDA Approves Selegiline Patch for Depression - PRNewswire; 2006-02-28 Unhealthy Alcohol Use - Richard Saitz, M.D., MPH; NEJM; 352(6): 596-607; 2005-02-10 Detox / Patient Engagement archives ; Abstinence / Harm Reduction Academic Lit |
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New! Anesthesia-Assisted vs Buprenorphine- or Clonidine-Assisted Heroin Detoxification and Naltrexone Induction -- "[Withdrawal] severities were comparable... [no differences] in rates of completion [or] retention [or urine tox]... The anesthesia procedure was associated with 3 potentially life-threatening adverse events. Conclusion: These data do not support the use of general anesthesia for heroin detoxification and rapid opioid antagonist induction." See also: Methods of Detoxification and Their Role in Treating Patients with Opioid Dependence Patrick G. O’Connor, M.D., MPH; JAMA; 294(8): 961-963; 2005-08-24. What is Ultra-Rapid Opiate detox (UROD) and how is it different from Rapid Opiate detox (ROD)? Alexander DeLuca, Addiction-related FAQ #18, 2001 Two Doctors May Lose Licenses Over Fast-Detox Method Medicine Associated Press; 2000-12-31 Heroin Detoxification - Michael M. Miller, Letter to the Editor, JAMA, 295(8): 885-886, 2006 |
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Comment
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Revised!
(2005-12-28) How Bad is Heroin Withdrawal? Jara A. Krivanek; Chapter in: "Heroin, Myths and Realities"; Allen & Unwin, Publishers; 1988.Posted 2001-10-09. Modified: 2005-12-28. -- Comment: An excerpt from the book: "Heroin, Myths and Reality." Discussion of withdrawal, with particulate reference to the harm that stems from the illegal status of the drug. These include shared paraphernalia, the 'heroin lifestyle' and it's accompanying violence, desperation, poverty, malnutrition and poor hygiene, adulterated drug, and overdose. See also: Occasional and Controlled Heroin Use - Not a problem? - Warburton et al., Joseph Rowntree Foundation; 2005. Evidence for Controlled Heroin Use? - Shewan and Dalgarno, British .J. Health Psych. 2005. |
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Treatments
for schizophrenia: a critical review of pharmacology and
mechanisms of action of antipsychotic drugs
by
Miyamoto et al.; Molecular Psychiatry; 2005. --
"[A]
brief review and critique of the current therapeutic
armamentarium for treating schizophrenia and drug
development strategies and theories of mechanisms of action
of antipsychotics, and focuses on novel targets for
therapeutic agents for future drug development." |
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Methadone
Maintenance vs 180-day Psychosocially Enhanced
Detoxification for Treatment of Opioid Dependence
by Sees, et
al. in JAMA 283(10); 1303-1310; 2000. (PDF) --
"Our results confirm
the usefulness of MMT in reducing heroin use and HIV risk
behaviors. Illicit opioid use continued in both groups but
frequency was reduced. Results do not provide support for
diverting resources from MMT into long-term detoxification." |
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Treatment
for Opioid dependence
by Bruce Rounsaville and
Thomas Kosten;
JAMA;
283(10); 1337 3/8/2000. --
"Implementation of
primary care treatment for substance use disorders offers
the possibility of increased access to care for these common
and undertreated disorders. Careful study will be required
to maintain and improve the quality of that treatment. " |
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Heroin addicts benefit from better
access to methadone by Reuters Health, 3/8/200. --
"More
heroin addicts in the US could get treatment if doctors were allowed
to dispense methadone in their office, according to results of a
study on such a program in two cities in Scotland." |
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Patient Selection and Detoxification Protocols;
by Alexander DeLuca, M.D.; Smithers Addiction Treatment and
Research Center, circa 1999. -- "Expert
detoxification is about more than the prevention of medical
and psychiatric complications. It is the provision of
non-judgmental, compassionate medical care. It is the
reassurance of patients who are frightened and ashamed. It
is the engagement of patients in a process of recovery that
can spare them decades of pain and misery."
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Office-Based Opiate Detoxification - An Open Letter to the FDA
by Alex DeLuca, M.D; 1998. -- An analysis of the forces promoting the increasing use of outpatient
treatment. Methods of opiate detoxification and medications are
reviewed. Conclusion: proscription of all opioid medications
in the treatment of opiate withdrawal is medically incorrect,
ethically questionable, and socially counterproductive. |
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Alcohol Dependence: Diagnosis, Clinical Aspects, and Biopsychosocial
Causes by J.'R. Volpicelli; From the Substance Abuse Library,
Copyright © 1997 by Treatment Research Center, University of
Pennsylvania. |
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Coping With Urges; Robert Westermeyer, Ph.D. --
Practical advice
about how to deal with urges and temptations of early recovery using
the "Three D's,"
Decatastrophizing, Disputing expectancies, and
Distracting. |
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Inpatient vs. Outpatient Detox? Criteria for deciding
by Alex DeLuca, M.D.; 1999. -- How to use assessment tools like the CIWA and the ASAM Patient
Placement Criteria towards making a rational decision. |
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Outpatient
Detoxification - Is This Really a Good Idea?
by Alex DeLuca, M.D.; 2000. -- From: Smithers Addiction News, Vol. 1, No. 1, Pages 1-2. Discussion
of outpatient detoxification guidelines and controlling risks associated with
outpatient detox procedures. |
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High-Frequency Users Of Gamma-Hydroxybutyric Acid At Highest Risk
for Withdrawal Symptoms by Anne MacLennan;
American Journal on Addictions, Vol. 10, pp 232-4.; 2001 --
"High frequency users of
gamma-hydroxybutyric acid are at greatest risk for withdrawal
delirium and psychosis if use is stopped abruptly." |
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Gamma-Hydroxybutyrate Withdrawal Syndrome J.E. Dwyer,
et al.;
Annals of Emergency Medicine, Vol. 37, No. 2, pp 148-53; 2001. --
"Report on 8 cases in which a severe withdrawal syndrome followed
ingestion every 3 hours around the clock. The withdrawal syndrome
was accompanied initially by symptoms of anxiety, insomnia, and
tremor that developed soon after GHB discontinuation. These initial
symptoms may progress to severe delirium with autonomic
instability." (PDF) |
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GHB Dependence, Withdrawal, and Detoxification
by Alex DeLuca, M.D.; 2000. -- Answer to a question posed by a person requiring doses of GHB every
few hours. Review of (paltry) literature, discussion of several
cases, and links to web resources. |
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| Alexander DeLuca, M.D., FASAM |
Originally posted: 2004-08-30 |
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All Email to: adeluca@doctordeluca.com |
Most recently
revised: 2006-03-21 |
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