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Author |
Schirtz, Andrée; Hämmig, Robert; Broers, Barbara; Bösch, Lukas; Stohler, Rudolf |
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Title |
Suchtforschung des BAG |
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Book Chapter |
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Year |
2005 |
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Abbreviated Journal |
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Pages |
46-51 |
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Keywords |
treatment and maintenance; detoxification; randomized controlled trial; methadone maintenance; buprenorphine maintenance; Switzerland; drug substitution therapy |
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Abstract |
Within the Swiss Detoxification Coordination (SwiDeCo) framework, a number of randomised clinical trials on opiate detoxification took place, comparing different settings (in- and outpatient), medications (antagonists under anaesthesia, methadone, buprenorphine high/low dosage) and duration of treatment (fixed and flexible). A standard assessment with validated instruments and standard follow-up was used throughout all the studies. One study concerned neonatal opiate detoxification. The scientific framework offered by SwiDeCo provided an opportunity for links and exchange between different drug treatment centres (over 20 centres participated in the studies) and persons working in the field of substance abuse in Switzerland. Overall, 279 patients were included in the different trials, of whom three-quarters were male, on average 30 years old; multi substance abuse was frequent. All procedures to withdraw patients from opiates tested in the different trials resulted in an equally poor outcome regarding abstinence after 3 months (22%). There were no patient baseline characteristics predicting differences in outcome. However, in-patient detoxification resulted in higher short-term abstinence rates, but this advantage disappeared over time. Patients’ level of distress at baseline evaluation decreased independently of treatment outcome during the first three months. Therefore, there seems to be a beneficial, but outcome-independent, treatment initiation effect. Two patients died within 3 months of detoxification. Although we cannot formally conclude whether withdrawal treatment resulted in an excess mortality, this fact is disquieting. During the detoxification phase overdose prevention should be discussed. Finally, based on our study results and on similar results from other groups, we cannot recommend the UROD procedure for withdrawal. We would rather suggest engaging patients who insist on this treatment modality in outpatient treatment, where tapering of substitution opiates could be performed while monitoring resumption of heroin consumption or the consumption of other substances. Given the high relapse rates independent of the specific detoxification treatment offered, it is important to offer flexible treatment goals to patients undergoing withdrawal treatment, so that substitution treatment might be offered in case of failure. The technique is simple and can be applied by trained family doctors. |
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Bundesamt für Gesundheit (BAG) |
Place of Publication |
Berne |
Editor |
Bundesamt für Gesundheit |
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Language |
English |
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Notes |
Ganze Publikation auch vorhanden: 50-01048 |
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Call Number |
50-11778 |
Serial |
50196 |
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Author |
Klein, Michael |
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Title |
Das “Beste” für den Suchtkranken : Versorgungsstrukturen und Marktprinzipien, Beiträge des 9. Heidelberger Kongresses 1996 |
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Book Chapter |
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Year |
1997 |
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Keywords |
patient; addiction care; medical treatment method; rehabilitation; drug market; AOD consumption; policy recommendations |
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Publisher |
Neuland |
Place of Publication |
Geesthacht |
Editor |
Fachverband Sucht |
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Language |
German |
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Call Number |
50-11785 |
Serial |
50197 |
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Author |
Ladewig, D.; Petitjean, S.; Stohler, Ruedi; Déglon, Jean-Jacques; Livoti, S.; Uehlinger, C.; Waldvogel, D. |
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Title |
Suchtforschung des BAG 1996-98 : Band 1/4 : Grundlagenforschung = Recherches de l'OFSP en matière de dépendances 1996-98 : volume 1/4 : recherche fondamentale |
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Book Chapter |
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Year |
2000 |
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20-28 |
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Keywords |
buprenorphine; AOD dependence; opioids in any form; methadone maintenance; randomized controlled trial; drug substitution therapy |
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Abstract |
Fragestellung: In der vorliegenden kontrollierten Doppelblind-Studie wurde die Sicherheit und Wirksamkeit von sublingualen Buprenorphin-Tabletten mit oralem Methadon über sechs Wochen verglichen. Methodik: Die Studienteilnehmer wurden in den drei Zentren Basel, Genf und Freiburg rekrutiert. Die Stichprobe setzte sich aus 58 opiatabhängigen, ambulanten Patienten zusammen, welche die DSM-III-R-Kriterien für eine Opioidabhängigkeit erfüllten und eine Substitutionsbehandlung anstrebten. Die Patienten wurden randomisiert entweder einer Behandlung mit Buprenorphin oder mit Methadon zugewiesen. In den ersten drei Wochen wurde ein flexibler Dosierungsplan verwendet. Die zulässigen Tagesdosen betrugen für Buprenorphin (SL) 4, 8, 12 bzw. 16 mg/d und für Methadon 30, 60, 90, bzw. 120 mg/d. Die Buprenorphingruppe (n = 27) und die Methadongruppe (n = 31) unterschieden sich nicht bezüglich soziodemographischer Variablen und drogenanamnestischer Daten (Alter: 27,3 ± 5,9 Jahre, 81% Männer, 45% i.v. HeroinkonsumentInnen). Resultate: In der Maintenancephase (Studienwoche 6) betrugen die durchschnittlichen Dosierungen für Buprenorphin 10 mg/d und für Methadon 69 mg/d. Die Haltequote für Methadon war signifikant besser als für Buprenorphin (durchschnittliche Tage in Behandlung: 30 Tage für Buprenorphin und 40 Tage für Methadon; p<0.001). Bezüglich Anzahl opiatpositiver Urinproben gab es keine signifikanten Unterschiede (Methadon 65% vs. Buprenorphin 56%; p > 0,5). Die Anzahl opiatpositiver Urinproben nahm im Verlauf der Studie in beiden Gruppen signifikant ab. Vier Patienten, die mit Buprenorphin behandelt wurden, berichteten über unerwünschte Wirkungen (Kopfschmerzen, allergische Hautreaktionen), welche jedoch nicht häufiger auftraten als in der Methadongruppe. Zusammenfassend weisen diese Resultate auf eine gute Verträglichkeit und Wirksamkeit (Reduktion des Heroingebrauchs) sublingualer Buprenorphin-Tabletten in der Substitutionsbehandlung Opiatabhängiger hin. Hingegen war die Haltequote unter Methadon besser. |
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Publisher |
Bundesamt für Gesundheit (BAG) |
Place of Publication |
Bern |
Editor |
Bundesamt für Gesundheit |
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Language |
German |
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no |
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Call Number |
50-11814 |
Serial |
50198 |
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Author |
Deutsche Hauptstelle gegen die Suchtgefahren |
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Title |
Situation und Perspektiven der Suchtkrankenhilfe : Positionspapier 2001 |
Type |
Book Chapter |
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Year |
2001 |
Publication |
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Pages |
35-37 |
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Keywords |
quality control; Germany |
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Deutsche Hauptstelle gegen die Suchtgefahren (DHS) |
Place of Publication |
Hamm |
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Language |
German |
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no |
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Call Number |
50-13365 |
Serial |
50199 |
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Author |
Kühn, Robert; Birett, Karl |
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Title |
Natriumhypochlorit Lösung |
Type |
Book Chapter |
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Year |
1989 |
Publication |
Merkblätter Gefährliche Arbeitsstoffe |
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Keywords |
harm reduction |
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Publisher |
Ecomed-Storck |
Place of Publication |
Hamburg |
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Language |
German |
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Call Number |
50-02964 |
Serial |
59355 |
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Author |
various |
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Title |
Evaluationen im Bereich der Risikoverminderung und der Überlebenshilfe = Evaluations dans le domaine de la réduction des risques et de l'aide à la survie |
Type |
Book Chapter |
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Year |
2002 |
Publication |
Evaluationen des BAG im Suchtbereich 1990-2000 = Evaluations de l’OFSP en matière de dépendances 1990-2000 |
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Pages |
199-284 |
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Keywords |
harm reduction |
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Bundesamt für Gesundheit (BAG); Office fédéral de la santé publique (OFSP) |
Place of Publication |
Bern; Berne |
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Language |
German; French |
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ISBN |
3-905235-31-5 |
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Notes |
Zweisprachige Publikation Deutsch-Französisch; publication bilingue français-allemand |
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Call Number |
02.00-003 |
Serial |
55189 |
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Author |
Dietel, Manfred; Dudenhausen, Joachim; Suttorp, Norbert |
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Title |
Sonderdruck aus Harrisons Innere Medizin 2 : Kapitel 297, chronische Hepatitis |
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Book Chapter |
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Year |
2002 |
Publication |
Harrisons principles of internal medecine |
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Pages |
12 |
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Keywords |
health promotion; viral hepatitis |
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Publisher |
ABW Wissenschaftsverlag |
Place of Publication |
Berlin |
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German |
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3-936072-10-8 |
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Call Number |
07.02-014 |
Serial |
55190 |
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Author |
Uchtenhagen, Ambros |
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Title |
Gesundheits- und Krankheitskonzepte : ihre Komponenten und deren Stellenwert für Diagnostik, Therapie, Begutachtung |
Type |
Book Chapter |
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Year |
2005 |
Publication |
Medizinische Gutachten |
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Volume |
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Issue |
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Pages |
34 |
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Keywords |
patient assessment |
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Luzern |
Editor |
Riemer-Kafka, Gabriela |
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Language |
German |
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3-7255-4943-5 |
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Call Number |
08-003 |
Serial |
55191 |
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Author |
Hefele, Bernhard |
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Title |
Einführung in die Drogenbibliographie |
Type |
Book Chapter |
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Year |
1988 |
Publication |
Drogenbibliographie : Verzeichnis der deutschsprachigen Literatur über Rauschmittel und Drogen von 1800 bis 1984 : mit einer Übersicht über internationale Bibliographien : Band 1 : Bibliographie und Einführung |
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Volume |
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Pages |
v-xlv |
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Keywords |
miscellaneous |
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Publisher |
Saur |
Place of Publication |
München |
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Language |
German |
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3-598-10671-8 |
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no |
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Call Number |
29-024 |
Serial |
55192 |
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Author |
Wang, Zhengyan; Béroud, Gérald; Cheng, Maojin; Cheng, Shirong |
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Title |
Drug treatment and public security in the People's Republic of China |
Type |
Book Chapter |
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Year |
1998 |
Publication |
Drug treatment systems in an international perspective : drugs, demons, and delinquents |
Abbreviated Journal |
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Volume |
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Issue |
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Pages |
253-262 |
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Keywords |
AOD abuse; chemical addiction; epidemiology; HIV infection; Aids; treatment and maintenance; laws and regulations; detoxification; drug substitution therapy; research; education; public opinion on AOD; China |
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Publisher |
Sage Publications |
Place of Publication |
Thousand Oaks |
Editor |
Klingemann, Harald; Hunt, Geoffrey |
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Language |
English |
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ISBN |
0-7619-0543-X |
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no |
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Call Number |
50-a |
Serial |
55193 |
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