Withdrawal programs

 

Withdrawal or detoxification is when the patient aims to completely stop all opioids over a specified time frame by tapering down the dose of a drug substitute.

 

The patients must be highly motivated to make this change and in stable circumstances as enforced withdrawal is ineffective for sustained abstinence. There is also an increased risk of relapse and overdose due to the loss of tolerance.

 

Complete withdrawal can take up to 4 weeks in a residential setting and up to 12 weeks in the community, with the maintenance regime being resumed if abstinence is not sustained.

 

Methadone or buprenorphine are the preferred substitute drugs to be used and the patient should keep to the same drug currently used for maintenance. However, if the patient is detoxing straight from street heroin, then buprenorphine is preferred.