14915
document
Safety of injectable opioid maintenance treatment for heroin dependence . BACKGROUND There is a growing debate about injectable opioid treatment programs in many Western countries . This is the first placebo-controlled study of the safety of injectable opioids in a controlled treatment setting . METHODS Twenty-five opioid-dependent patients on intravenous ( IV ) heroin or IV methadone maintenance treatment were randomly assigned to either their individual prescribed IV maintenance dose or placebo . Acute drug effects were recorded , focusing on electrocardiography , respiratory movements , arterial blood oxygen saturation , and electroencephalography ( EEG ) . RESULTS After heroin injection , marked respiratory depression progressing to a Cheyne-Stokes pattern occurred . Peripheral arterial blood oxygenation decreased to 78.9 +/- 8.7 % ( mean +/- SD ) ranging from 52 % -90 % . During hypoxia , 7 of the 16 subjects experienced intermittent and somewhat severe bradycardia . Five subjects exhibited paroxysmal EEG patterns . After methadone injection , respiratory depression was less pronounced than after heroin injection . No relevant bradycardia was noted . CONCLUSIONS Opioid doses commonly prescribed in IV opioid treatment induce marked respiratory and circulatory depression , as well as occasionally irregular paroxysmal EEG activity . Further studies are needed to optimize the clinical practice of IV opioid treatment to prevent serious complications . Moreover , the extent of the observed effects raises questions about the appropriateness of IV opioid treatment in the present form .
14916
Intervention_Physical
injectable opioid maintenance treatment
14917
Intervention_Physical
injectable opioid treatment programs
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Intervention_Control
placebo-controlled
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Intervention_Pharmacological
injectable opioids
14920
Intervention_Pharmacological
intravenous ( IV ) heroin
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Intervention_Pharmacological
IV methadone maintenance treatment
14922
Intervention_Pharmacological
individual prescribed IV maintenance dose
14923
Intervention_Control
placebo
14924
Intervention_Pharmacological
heroin injection
14925
Intervention_Pharmacological
methadone injection
14926
Intervention_Pharmacological
heroin injection
14927
Intervention_Pharmacological
Opioid
14928
Intervention_Pharmacological
IV opioid treatment
14929
Intervention_Pharmacological
IV opioid treatment
14930
Intervention_Pharmacological
IV opioid treatment
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Outcome_Other
Acute drug effects
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Outcome_Other
electrocardiography
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Outcome_Physical
respiratory movements
14934
Outcome_Physical
arterial blood oxygen saturation
14935
Outcome_Physical
electroencephalography ( EEG )
14936
Outcome_Physical
respiratory depression
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Outcome_Physical
Cheyne-Stokes pattern
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Outcome_Physical
Peripheral arterial blood oxygenation
14939
Outcome_Physical
hypoxia
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Outcome_Physical
bradycardia
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Outcome_Physical
paroxysmal EEG patterns
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Outcome_Physical
respiratory depression
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Outcome_Physical
bradycardia
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Outcome_Physical
respiratory and circulatory depression
14945
Outcome_Physical
irregular paroxysmal EEG activity
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Participant_Condition
heroin dependence
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Participant_Sample-size
Twenty-five
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Participant_Condition
opioid-dependent patients
14949
Participant_Sample-size
16 subjects