The common detoxification method is replacement of long effect opiate by short effect opiate and then reducing its amount gradually. More modern method is ultra rapid opiate detoxification (UROD) by opiate antagonists, which is performed by general anesthesia. The advantages of two methods have not been confirmed. This study aimed to compare effectiveness and withdrawal rate in both methods following up to a year. 211 self-introduced patients who referred to Farabi hospital for withdrawal were enrolled in this cross sectional study during 2005-06. The patients underwent detoxification after psychiatry screening and addiction confirmation. They divided into two detoxified method groups (110 patients in UROD and 101 Methadone). Recurrent and suspected cases were confirmed or rejected by urinary test and more specific test respectively. Data was collected from available patients profiles and contacting with patients or their relatives and was analyzed using Chi-square & independent sample T-test. The results showed that addiction recurrent in UROD and Methadone groups was 35.7% and 56.4% respectively (P=0.002). The average age of recurrent subjects in UROD group was younger than successful population at that same group (27.95±5.2 vs. 31.4±7.1 years old, p=0.008). This study suggested that chance of detoxification and successful withdrawal by UROD method is higher than Methadone method and younger patients are more likely to get the recurrence. It is recommended to compare these two methods in a prospective study by unifying both groups based on age and considering opiate use duration.

According to obvious changes in drug abuse patterns in recent years, the main purpose of this study was to reassess the effect of demographic and other individual factors on the drug treatment process

In this analytic-descriptive study, data collected in Tehran’s Welfare Organization drug treatment outpatient clinics (both private and non-private clinics). 8 clinics were selected (based on a triage classification of clinics, according to the quality of services registered in governmental experts’ records) Demographic and individual variables extracted from the1372 existing files in the treatment centers. Then data processed by multivariable logistic regression.

In this study 258 records (18.8%) of patients revealed successful completion of detoxification phase, The final multiple regression model’s results showed that: 1- Crack user clients had 1.49 times more unsuccessful detoxification, (P=0.5), 2- Clients with drug use frequency once daily showed 2.4 times more successful completion in drug detoxification than users with the frequency of 4 times a day, (P=0.01), 3- Also clients with drug free close relatives and home mates had 1.8 times more succession in drug detoxification (P<0.01) and 4- Crack user patients presented with psychological or somatic signs and symptoms had 1.94 times more succession in treatment than others without these symptoms.

New patterns of drug use reveal the importance of reassessing the effect of demographic factors and severity and depth of drug use on the treatment process (as well as quality assurance of services).

Drug addiction and drug dependency are major problem in the “mental”,”social”, and “health-care” fields. It decreases occupational performance and educational abilities in different social groups, and may lead to miscellaneous crimes. Different methods are recommended for drug addiction treatments. Detoxification is the first step however it would not be successful without follow up and vigorous maintenance therapy. Naltrexone introduced as an opium antagonist to decrease desire for opiates and is used for maintenance therapy of drug treatments in Kermanshah Rehabilitation and Therapy Center since 2001. This study aimed to determine the relapse rates of drug addict patients under maintenance therapy by Naltrexone after 18 months follow up. 150 drug addicts who were admitted in Kermanshah Rehabilitation and Therapy Center were recruited flowing detoxification period. They received Naltrexone maintenance therapy for six months and followed for 12 months to find out their drug addiction relapse. Opium test (T.L.C) were measured monthly during six months and followed with three-month intervals for next 12 months. Relapse rate in the maintenance therapy period were 56.7% and 4.7% respectively. The achievement rate was 38.7%. Socio-demographic findings showed that relapse rate were highest in young adults (18-25 years old) and lowest in employed subject. According to the drug type, consumption method and interval; heroin users, drug inhalation and 2-3 times daily users showed more achievements than other drug addicts. We conclude that the first nine months after detoxification is more critical period, Naltrexone maintenance therapy, helps to long lasting give up drug addiction. The employees and subjects with well social discipline and educational background have more chance to stop opium abuse.

Opioid dependence has recently been considered as a social issue as well as a physical disease which requires treatment on its own turn. At present there are numerous methods for opium detoxification. The fastest method is UROD. In this approach the patient undergoes general anesthesia or sedation and is detoxified using opioid antagonists during 6-8 hours. Though sometimes associated with certain unwanted side effects، this approach has been recognized as a convenient one due to advantages suck as: short time required for treatment، complete detoxification، total patient unconsciousness when painful withdrawal symptoms occur، quick recovery and return to daily activities and short interval between the last episode of opiod abuse and initiation of mainteance therapy with oral opioid antagonists. This article coveres a review of literature، indications، contraindication، methodology،side effects، advantages and disadvantages of the UROD method. Additional researches with a larger number of samples which increase the validity of the research issue will change the above mentioned approach to an ideal method of detoxification.

Zebrafish (Danio rerio) stands as a valuable model organism for delving into molecular mechanisms, notably detoxification. MicroRNAs (miRNAs), small non-coding RNA molecules, serve as post-transcriptional regulators of gene expression, potentially shaping the complex network of genes engaged in detoxification pathways. This study employs bioinformatic analysis, utilizing Target Scan and DIANA databases, to explore the potential of miRNAs in modulating the expression of detoxification-associated genes in zebrafish. By meticulously scrutinizing miRNA and mRNA datasets in zebrafish, we pinpoint candidate miRNAs predicted to target established detoxification genes. Leveraging bioinformatic algorithms, we dissect the plausible interactions between these miRNAs and their target detoxification genes, which include pgp, gpx1a, gpx3, aldh3b1, gstm3, cyp3c1, gstp1, gpx1b, cyp17a1, sod1, sod2, gsto2, gstz1, akr7a3, gsr, ahr1b, cat, ahr2, and abcb4. Moreover, we assess the conservation of miRNA-target interactions across species and scrutinize potential miRNA binding sites within the 3' untranslated regions (UTRs) of target mRNAs. Our findings unveil the intricate regulatory interplay between miRNAs and genes involved in detoxification in zebrafish, providing a cornerstone for future experimental validations. This study significantly contributes to our evolving understanding of miRNA-mediated gene regulation within the context of detoxification pathways in zebrafish

This paper aims at evaluating and selecting the most suitable detoxification method among the following four symptom method, replacement method, rapid opiate detoxification and ultra-rapid opiate detoxification. Thirty experts considered the four detoxification methods and rated the 7 criteria on a 1-9 scale -basis. Then, after making a decision-making matrix, the four methods were prioritized and the best was chosen through the next six-stages of the TOPSIS technique. The replacement method was closer to positive criteria and more distant from negative ones in compare with other methods (Ci =0.653446). According to these findings, the replacement method turned out to be the most suitable method of detoxification.

In this study the efficacy of traditional method, methadone tapering method and rapid method as three opiate detoxification treatments was compared based on demographic features and naltrexone consumption in a 6- month follow up. This Cohort prospective study was performed on 140 opioid addict men referred to opiate detoxification center of Shahid Beheshti Hospital, Kerman/ Iran from 2005-2007. They were divided into three groups of traditional method (n= 61), methadone tapering (n= 34) and rapid treatment (n= 45) and followed up for 6 months in order to evaluate the results of detoxification treatments. At the end of the first month, the rate of abstinence in whole was 80.7%, and this rate was 83.6% in traditional treatment group, 82.4% in methadone group and 75.6% in rapid treatment group that shows no significant difference. After the 6th month the rate of abstinence was 12.8% in whole, 16.7% in traditional treatment group, 16.7% in methadone group and 6.3% in rapid treatment group. These rates, too, show no significant difference among three groups. The rate of naltrexone consumption at the end of the 1st month was 75.7% in whole, 52.5% in traditional group, 47.1% in methadone group and 97.8% in rapid treatment group that shows significant difference among three groups (P<0.05). There was no case of naltrexone consumption at the end of the 6th month. Since the rate of relapse and results of three detoxification methods have been the same the best detoxification method for each patient should be selected based on the physical condition of the patient, available facilities, probable expenses and physician's clinical judgment.

The efficacy of high doses of buprenorphine prescription in one day was compared with the usual method. In a double-blind trial, 40 patients with the diagnosis of opioid dependence (based on DSM- IV criteria) were randomly assigned into two groups. 20 patients received 12 mg of buprenorphine intramuscularly in divided doses during one day long 20 other patients were administered the usual decreasing doses of buprenorphine over five days. The followings were evaluated: success rate in detoxification, treatment retention in days, intensity of subjective withdrawal symptoms, intensity of objective withdrawal symptoms, level of drug craving, level of adjuvant drug use, drug side-effects, rate of positive urine tests for opioids, and levels of hepatic enzymes. Data were analyzed via statis- tical c2, t, Mann-Whitney, and Fisher tests. There was no significant difference between the two groups across most variables. The only difference observed was when the most withdrawal symptoms were evident, which was in the initial part of detoxification for the one-day treatment group and also at the end of the period for the five-days treatment group. To shorten the detoxification period, the one-day and high doses of buprenorphine treatment can be beneficial even though further evaluations with a larger sample may be required. However, the use of injectable buprenorphine is not recommended in routine clinical practice, because of its possible abuse and serious side effects.