Opiate Detox and withdrawal
Opiate withdrawal is mostly considered less likely to produce mortality compared with sleeping pills and benzodiazepines. Safe withdrawal from heroin or pain pills is termed detoxification and can be performed as outpatient or inpatient treatment, depending upon certain facts including presence of comorbid medical and psychiatric problems, availability of family support, and multidrug abuse.
Methadone, buprenorphine, and suboxone are successful methods also, alpha-2 agonists, such as clonidine and lofexidine, are commonly used prescribed methods of detoxification. The use of subutex and buprenorphine is mostly based on cross-tolerance , a principle in which one opioid is replaced with another and then slowly tapered. Alpha-2 agonists used for opiate detox appear to be most effective in suppressing signs and symptoms of withdrawl , but they are less effective for subjective symptoms.
Subutex, a form of Buprenorphine was associated with less adverse effects than clonidine, and patients were more likely to complete opiate detox with buprenorphine or subutex compared with clonidine. Moreover, a second random trial demonstrated that subutex was more effective than clonidine for opioid detoxification. Buprenorphine and methadone were equally effective for withdrawal completion, but withdrawal symptoms appeared to resolve more quickly with subutex or buprenorphine.