Methadone Contrasted with Acetaminophen Codeine plus Clonidine: An Inpatient Pilot Study

S. Shafti
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Abstract

The mainstay of pharmacological management of opioid dependence is opioid substitution treatment. Methadone is a long‐acting opioid agonist, which is used for detoxification and maintenance of opioid-dependent people. Objective of the present evaluation included a comparison between methadone and acetaminophen codeine plus clonidine for management of opioid withdrawal symptoms. All patients of an acute ward of a psychiatric hospital, who met dual diagnosis of primary psychiatric disorder plus opioid use disorder, were selected as accessible sample for the current evaluation. Duration of assessment was around elven months and the study was performed according to a single-blind plan. Among 96 patients, cases, who were using methadone, before their recent admission in hospital, continued their substitution treatment according to the recommended dosage and formulation till release (n = 42). The remaining group of patients, had been given acetaminophen codeine plus clonidine, as substitution treatment, during their inpatient management (n = 54). The primary outcome measures were the ‘Cross-Cutting Symptom Measure’ and the ‘Subjective Opiate Withdrawal Scale’, which were scored at baseline, week 1 and week 2. The study was performed according to the ‘per-protocol’ analysis, and the assessor was blind with respect to the said protocols. while the mean total score of primary outcome measures decreased significantly in both groups, the between-group analysis did not show any significant difference between these two groups in a head-to-head analysis. Acetaminophen codeine plus clonidine was as good as methadone for management of opioid withdrawal symptoms in inpatient setting.
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美沙酮与对乙酰氨基酚、可待因加可乐定对比:一项住院病人的初步研究
阿片类药物依赖的主要药理管理是阿片类药物替代治疗。美沙酮是一种长效阿片类激动剂,用于阿片类药物依赖者的解毒和维持。本评价的目的包括美沙酮与对乙酰氨基酚可待因加可乐定治疗阿片类戒断症状的比较。所有精神病院急性病房的患者,符合原发性精神障碍和阿片类药物使用障碍的双重诊断,被选为当前评估的可访问样本。评估时间约为11个月,研究按单盲计划进行。96例患者中,近期入院前正在使用美沙酮的患者继续按照推荐剂量和处方进行替代治疗,直至释放(n = 42)。其余组患者在住院期间给予对乙酰氨基酚可待因加可乐定作为替代治疗(n = 54)。主要结果测量指标为“交叉症状测量”和“主观阿片戒断量表”,分别在基线、第1周和第2周进行评分。研究是根据“每协议”分析进行的,评估员对上述协议是盲目的。虽然两组主要结局指标的平均总分均显著下降,但组间分析在头对头分析中未显示两组之间有显著差异。对乙酰氨基酚、可待因加可待因治疗住院患者阿片类戒断症状的效果与美沙酮一样好。
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