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Rapid and Ultra-Rapid Detoxification in Adults With Opioid Addiction: A Review of Clinical- and Cost-Effectiveness, Safety, and Guidelines

Last updated: January 15, 2016
Project Number: RC0742-000
Product Line: Rapid Response
Research Type: Devices and Systems
Report Type: Summary with Critical Appraisal
Result type: Report

Question

  1. What is the clinical effectiveness and safety of rapid and ultra-rapid opioid detoxification (ROD and UROD) in adults with opioid addiction?
  2. What is the cost-effectiveness of ROD and UROD in adults with opioid addiction?
  3. What are the evidence-based guidelines associated with the use of ROD and UROD in adults with opioid addiction?

Key Message

There is some evidence suggesting earlier peaking of, and lower scores for, withdrawal symptoms and higher rates of the commencement and continuation of maintenance treatment in patients receiving UROD, compared to patients in control groups (e.g., conventional withdrawal treatment). However, no significant differences were identified between UROD and control groups in the commencement or duration of withdrawal treatment. Mixed results were identified between UROD and control groups in the completion of withdrawal treatment and the incidence of adverse events, depending on what pharmacologic agents were used. One guideline recommended against the use of UROD, due to high risk for adverse events. No evidence on ROD or on cost-effectiveness of ROD and UROD was identified.