Placebo and analgesic nitrous oxide for treatment of the alcohol withdrawal state

Article Abstract:

Alcohol withdrawal syndrome includes such symptoms as tremor, weakness, perspiration, nausea, anorexia, insomnia, and irritability, and usually occurs within 12 hours of alcohol cessation in chronic drinkers. Most often, the symptoms are mild to moderate in severity. Up until 24 hours after the last drink, hallucinations may be present, and between 24 and 48 hours, the patient may have convulsions. If untreated, delirium tremens, a life-threatening condition, may occur on the third or fourth day. Benzodiazepines have been the treatment of choice for alcohol withdrawal syndrome, but their use has been criticized because they too can lead to dependence. This has lead to a search for other therapeutic drugs without this side effect. In the present study, the usefulness of analgesic nitrous oxide in treating the alcohol withdrawal state was compared with the effects of a placebo. A total of 104 males, aged 28 years to 60 years, with at least a 10-year history of alcohol abuse, were evenly divided into two treatment groups. One group received oxygen gas and the other group received carbogen (95 percent oxygen and 5 percent carbon dioxide). Both were considered placebos, and both had a therapeutic effect just over half the time. Those who failed to respond to either placebo were then given analgesic nitrous oxide, to which 87 percent responded within 20 minutes. It is concluded that analgesic nitrous oxide is a safe, effective, and quick-acting alternative to benzodiazepines in treating alcohol withdrawal syndrome. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Alcoholism, Nitrous oxide, Alcoholic myopathy

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A comparison of the withdrawal responses of heroin and methadone addicts during detoxification

Article Abstract:

Many heroin addicts find that withdrawal from methadone, a synthetic opiate, is similar to but more severe than withdrawal from heroin. In order to compare the relative severity and persistence of withdrawal symptoms from both drugs, 60 men and 23 women consecutively admitted to an inpatient drug treatment unit for opiate dependency were studied. Forty-five of the patients were primarily dependent on heroin, and 38 on methadone. Their inpatient withdrawal agenda involved daily reductions from individual starting doses of methadone. Starting doses for the heroin-dependent patients were assessed by converting heroin to methadone equivalency. Withdrawal responses were measured by a 12-item opiate withdrawal scale on which patients rated withdrawal symptoms (e.g., stomach cramps, muscle spasms, coldness, goosebumps, pounding heart, muscular tension, aches or pains, weakness, runny eyes and insomnia) as nil (0 points), mild (1 point), moderate (2 points) or severe (4 points). Withdrawal scale scores were compared between the heroin and methadone groups during the acute withdrawal phase (days 1 through 13) and the recovery phase (days 14 through 23). The methadone-addicted group had significantly higher scores during both stages. During the acute phase, methadone addicts reported higher symptom levels on every scale item. Neither the dosage of opiates used before admission or the initial withdrawal dose were found to be related to withdrawal severity or rates at which withdrawal symptoms appeared or declined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Physiological aspects, Methadone maintenance, Heroin habit

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