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To the Editor: Great Britain is in the early stages of a new heroin epidemic, often involving very young users.¹ Traditionally, treatment for heroin addiction substitutes methadone hydrochloride for heroin, often followed by gradual tapering of the methadone dose. However, this method is often unsuccessful because of high dropout and subsequent relapse rates. Furthermore, most study designs have had limited assessment of clinical outcomes.²

Methods

In a pilot study of 30 patients, we compared rapid detoxification with naltrexone under general anesthesia followed by long-term naltrexone use (rapid detoxification) with the traditional management of heroin addiction by substituting it with methadone, followed by gradual tapering of the methadone dose and long-term naltrexone (traditional methadone). After giving informed consent, the first 15 eligible patients were assigned to rapid detoxification and the next 15 to traditional methadone treatment. All patients were followed up for 3 months. During this time, treatment effectiveness was assessed by . . . [Full Text of this Article]

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