Treatment of withdrawal includes supportive care and medications. Unfortunately, the most commonly used medication, clonidine, primarily reduces physical symptoms but does not address craving or anxiety.
Another detox method is to use a slowly tapered dose of methadone to reduce the intensity of withdrawal symptoms. This can be effective in inpatient programs, but outpatient methadone detox programs are ineffective.
Methadone maintenance, however, which involves indefinite use of methadone, is the most effective treatment for opiate addiction according to the Institute of Medicine. For those who repeatedly fail detox, methadone maintenance should be strongly considered.
The FDA is expected to approve a new medication for use in the treatment of opiate withdrawal (called buprenorphine) this year. This medication may help both physical and mental withdrawal symptoms, and it may also be used for long-term maintenance like methadone.
This will have significant advantages over methadone because it will be obtainable from general practitioners, not just specialized clinics with rigid attendance requirements.
Note: Some drug treatment programs have widely advertised treatments for opiate withdrawal called "detox under anesthesia" or "rapid opiate detox." This involves anesthetizing the patient and injecting large doses of opiate-blocking drugs, with hopes that this will speed up the transition to normal opioid-system function.
There is no evidence that these programs actually reduce time spent suffering withdrawal. In some cases, they may reduce the intensity of symptoms. However, there have been several deaths associated with the procedure, particularly when it is performed outside a hospital.
Because opiate withdrawal produces vomiting, and vomiting during anesthetia significantly increases death risk, many specialists think the risks of this procedure significantly outweigh potential (and unproven) benefits.
