(October 10th, 2002)
Why the medical community does not believe in Rapid Detox.
Rapid detox, involving the use of an opiate antagonist and anasthesia, was developed during the late 1980s. Known also as ultra-rapid detox or neuro-regulation, rapid detox has many critics.
The medical establishment is leery of a quick fix that costs as much as $10,000, is not covered by insurance and has not been compared in peer-reviewed clinical trials with traditional treatments. NeuroRegulation and rapid detox is not FDA approved and it has been related to several deaths nationwide.
Many psychiatrists including, Dr. Charles O’Brien, a psychiatry professor at the University of Pennsylvania, argues that the treatment is a quick-fix method that does not cure the addict. “I don’t see any value in this new treatment,” said O’Brien. Other critics point to a National Institute of Drug Abuse (NIDA) report that warned of complications with the procedure that are “unacceptable” considering the unproven nature of the treatment. The NIDA report notes that “detoxification is not a cure for opiate addiction.” Furthermore, the NIDA report says patients may be at risk of choking or cardiac complications when given large quantities of detox drugs in combination with anesthesia.
Dr. Robert Newman, an addiction specialist at Beth Israel Hospital in New York says the treatment is not enough. “Relapse is the rule rather than the exception,” he said. “The idea that people can leave with a bag of Naltrexone® pills and the number of the local chapter of Narcotics Anonymous and stay off heroin, that’s wishful thinking.”
Some detox facilities include psychological counseling but that is not enough for the psychological addiction to opiates.
Although it has been claimed to be a “painless withdrawal”, the reality seems to be that most patients experience discomfort ranging from mild to distressing on awaking from the anesthetic. Current rapid detox protocols keep patients asleep for some hours of the withdrawal and when the patient wakes up they are in pain, presenting most of the withdrawal symptoms. These symptoms slowly improve, although some like nausea may last from a period of weeks to months.
Withdrawal from opiates has two distinct phases, the acute withdrawal and the residual withdrawal. Residual withdrawal symptoms include: insomnia, restlessness, depression and drug craving. Rapid detox does nothing to address the residual withdrawal symptoms and the naltrexone that is administered after a rapid detox procedure does not diminish drug craving.
Detoxing under a general anesthetic is a major medical procedure. The body undergoes extreme trauma during the detox, and general anesthetics (especially of such long duration) are inherently risky procedures. Fatalities while under anesthetic have been reported. In New Jersey alone there have been 7 reported deaths. The total number nationwide is not available.
Federal officials called those deaths unacceptable.
With rapid detox patients are in and out of the hospital in two days, aftercare includes naltrexone, telephone counseling and referrals to the local chapters of Narcotics Anonymous.
There are a handful of clinics that advertise on the Internet, and an unknown number of doctors nationwide perform the procedure secretly.
“There have been some studies that showed limited results with rapid detox,” says H. Westley Clark, director of the Center for Substance Abuse Treatment at the U.S. Department of Health and Human Services.
Money and risks aside, “It’s one thing getting people drug-free,” says Ron Jackson, a social worker at Evergreen Treatment Services, a Seattle methadone clinic. “It’s another trying to keep them drug-free.”
Many rapid detox patients who were interviewed after their procedure said that they felt “emptiness” and fatigue, dizziness and nausea were common complaints as well. Most patients report body aches and intense drug craving.