Self-detoxification attempts among methadone maintenance patients: what methods and what success?

In a study of patients attending a methadone maintenance clinic in South London, 66 of 114 (58%) had previously attempted to detoxify themselves from opiates without medical assistance. The total number of self-detoxification attempts was 237, an average of 3.6 attempts per individual. Forty subjects (61%) reported attempting self-detoxification with the help of drugs or alcohol. The drugs most commonly used were diazepam, alcohol, and cannabis. The most commonly reported reasons for attempting self-detoxification were "fed-up with the lifestyle" (61%) and "for their family" (12%). The reasons given for why patients had decided to detoxify themselves rather than access treatment services included 23% who reported that "they could cope on their own and that they didn't need any help." The short-term success rate (abstinent for at least 24 hours) was moderate, at 41% (97/237). Patients who had been unsuccessful were asked why their last self-detoxification attempt had not resulted in abstinence, with 27% reporting that they were "tempted to use again" and 23% reported that they "didn't know why they started using again." The prevalence of both attempts and success suggests that, for some opiate users, self-detoxification may be a pathway to abstinence.

[1]  T. Stockwell,et al.  Home detoxification for problem drinkers: acceptability to clients, relatives, general practitioners and outcome after 60 days. , 1990, British journal of addiction.

[2]  N. Fleeman Alcohol home detoxification: a literature review. , 1997, Alcohol and alcoholism.

[3]  Robert Schasre Cessation Patterns among Neophyte Heroin Users1 , 1966 .

[4]  D. B. Cooper Alcohol home detoxification: a way forward. , 1995, British Journal of Nursing.

[5]  B. Cantwell,et al.  Self detoxication by amphetamine dependent patients: a pilot study. , 1998, Drug and alcohol dependence.

[6]  T. Stockwell,et al.  Home detoxification from alcohol: its safety and efficacy in comparison with inpatient care. , 1991, Alcohol and alcoholism.

[7]  D. B. Graeven,et al.  Treated and Untreated Addicts: Factors Associated with Participation in Treatment and Cessation of Heroin Use , 1983 .

[8]  Alan Ross,et al.  The Effectiveness of Methadone Maintenance Treatment , 1991, Springer New York.

[9]  P. Biernacki,et al.  Natural Recovery from Heroin Addiction: A Review of the Incidence Literature , 1979 .

[10]  Ronald C. Kessler,et al.  Comparative epidemiology of dependence on tobacco, alcohol, controlled substances, and inhalants: Basic findings from the National Comorbidity Survey. , 1994 .

[11]  D. Gerstein,et al.  Treating drug problems. , 1990, The New England journal of medicine.

[12]  M. Farrell,et al.  The Maudsley Addiction Profile (MAP): a brief instrument for assessing treatment outcome. , 1998, Addiction.

[13]  P. Biernacki,et al.  Spontaneous remission from the problematic use of substances: an inductive model derived from a comparative analysis of the alcohol, opiate, tobacco, and food/obesity literatures. , 1986, The International journal of the addictions.

[14]  W. Saunders,et al.  Domiciliary detoxification: a cost effective alternative to inpatient treatment. , 1994, The Australian journal of advanced nursing : a quarterly publication of the Royal Australian Nursing Federation.

[15]  C. Bennie A comparison of home detoxification and minimal intervention strategies for problem drinkers. , 1998, Alcohol and alcoholism.

[16]  P. Biernacki,et al.  The Natural Recovery from Opiate Addiction: Some Preliminary Findings , 1981 .

[17]  J. Strang,et al.  Self-detoxification by Opiate Addicts , 1991, British Journal of Psychiatry.

[18]  J. Jorquez The Retirement Phase of Heroin Using Careers , 1983 .

[19]  L. Sobell Drug Abuse Treatment: A National Survey of Effectivenes , 1991 .