Comparison of linear versus inverse exponential methadone reduction curves in the detoxification of opiate addicts
Abstract
A linear methadone detoxification procedure is compared with an inverse exponential reduction curve in a double-blind study. The inverse exponential curve resulted in withdrawal symptomatology which was significantly greater during the acute phase of the opiate withdrawal curve and was not significantly different during the recovery phase. There was no difference between groups in the time course of the withdrawal syndrome, in peak symptom severity, nor in patient compliance. Separate analyses for high-dose and for low-dose addicts show variation in the suitability of the two curves according to dose. The implications for future research and treatment of the opiate withdrawal syndrome are discussed.
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The Burroughs quotation illuminates a nonlinear method of exponential dose reduction, where each reduction in dose becomes smaller and smaller, that had also been suggested in 1990.
“The Burroughs quotation at the beginning of this paper illuminates a rather different, nonlinear method of tapering; a method of exponential dose reduction (where each reduction in dose becomes smaller and smaller) – that had also been suggested in 1990. 15”
From Tapering and withdrawing opioids: guidance informed by fundamental principles to minimise withdrawal symptoms (2025) · cites this paper as [15]
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Self-citation
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Dunn, K. E., Sigmon, S. C., Strain, E. C., Heil, S. H., & Higgins, S. T. (2011) · Drug and Alcohol Dependence · doi:10.1016/j.drugalcdep.2011.05.033 · Cited by 65 · see citing works
“Magnitude decrease has been associated with differential outcomes following methadone detoxification, yet it is not clear this finding will generalize given buprenorphine’s unique pharmacological profile (Strang and Gossop, 1990).”
BackgroundAbie Horowitz, M., Framer, A., Strang, J., & Taylor, D. (2025) · Therapeutic Advances in Psychopharmacology · doi:10.1177/20451253251371504
“15 In fact, some existing guidelines do recommend similar patterns of tapering.”
Self-citation
- Authors
- Strang, J., & Gossop, M.
- Affiliations
- Bethlem Royal Hospital (GB)
- King's College London (GB)
- Corresponding author
- Strang, John
- Venue
- Addictive Behaviors
- Publisher
- Elsevier BV
- Published
- 1990-01
- Volume
- 15
- Issue
- 6
- Pages
- 541-547
- ISSN
- 0306-4603 (ISSN-L)
- OpenAlex
- W1965443278
- Cited by
- 42
- References
- 20
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 1 · 2022: 1 · 2020: 1 · 2018: 1 · 2015: 1 · 2013: 1 · 2012: 1
- FWCI
- 1.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Addictive Behaviors (publishedVersion)
- PubMed (publishedVersion)
- Research Portal (King's College London) (submittedVersion)
- 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
- methadone detoxification, opioid withdrawal, methadone dose, withdrawal symptom severity, medication adherence
- MeSH terms
- Adult, Dose-Response Relationship, Drug, Double-Blind Method, Drug Administration Schedule, Female, Heroin Dependence, Hospitalization, Humans, Male, Methadone, Neurologic Examination, Substance Withdrawal Syndrome
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