Outpatient Treatment of Prescription Opioid Dependence: Comparison of Two Methods
Abstract
Twenty-one patients dependent on prescription opioids were treated by 21-day detoxification followed by psychotherapeutic counseling (D/C), and 21 patients were detoxified 21 days and provided opioid maintenance if detoxification was unsuccessful (D/M). Only five of 21 (23.8%) patients in the D/C group compared with 20 of 21 (95.2%) in the D/M group completed three weeks of treatment. No patient initially perceived that chronic pain due to a medical condition would be an impediment to withdrawal from opioids, but pain that was masked by opioid dependency and that emerged during detoxification proved to be an insurmountable barrier to total withdrawal in the majority of patients. Treatment of outpatients with dependence on prescription opioids is best provided by opioid maintenance therapy and adjunctive pain therapy.
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Methadone or propoxyphene treatment produced better treatment retention than detoxification followed by psychotherapy in patients with chronic pain and co-existent addiction.
“Similarly, Tennant and Rawson showed that methadone or propoxyphene treatment produced better treatment retention than detoxification followed by psychotherapy in patients with chronic pain and co-existent addiction.28”
From A Preliminary Study Comparing Methadone and Buprenorphine in Patients with Chronic Pain and Coexistent Opioid Addiction (2013) · cites this paper as [28]
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- Authors
- Tennant, F. S.
- Corresponding author
- Tennant, Forest S.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 1982-10-01
- Volume
- 142
- Issue
- 10
- Pages
- 1845
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W1998409214
- Cited by
- 53
- References
- 20
- Citations by year
- 2025: 1 · 2024: 1 · 2022: 4 · 2021: 3 · 2020: 2 · 2019: 1 · 2018: 4 · 2017: 2 · 2016: 8 · 2015: 2 · 2013: 3
- FWCI
- 2.72
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Internal Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Epidemiology › Substance Abuse Treatment and Outcomes
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- prescription opioid dependence, outpatient care, opioid detoxification, opioid maintenance treatment, chronic pain, withdrawal, treatment completion
- MeSH terms
- Adult, Aged, Ambulatory Care, Female, Humans, Male, Middle Aged, Opioid-Related Disorders, Narcotics, Pain, Palliative Care, Prognosis, Psychotherapy
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