[Ibogaine] Fw: Some Canadian figures on withdrawals after rapid detox( added commentary by layperson).

Ron Davis rwd3 at cox.net
Mon Aug 1 09:46:02 EDT 2005

  ----- Original Message ----- 
  From: Preston Peet 
  To: ibogaine at mindvox.com ; drugwar at mindvox.com 
  Sent: Sunday, July 31, 2005 10:01 PM
  Subject: [Ibogaine] Fw: Some Canadian figures on withdrawals after rapid detox.

  ----- Original Message ----- 
  From: Andrew Byrne 
  To: ajbyrne at ozemail.com.au 
  Sent: Sunday, July 31, 2005 9:26 PM
  Subject: Some Canadian figures on withdrawals after rapid detox.

  Measurement of Symptom Withdrawal Severity in a 24-Hour Period After the Anesthesia-Assisted Rapid Opiate Detoxification Procedure. Teplin D, Raz B, et al.  American Journal of Drug and Alcohol Abuse (2005) 31;2:327-335


  Dear Colleagues, 

  These authors from Canada should be commended for joining the small group who report aspects of outcomes after commercial rapid detox procedures.  However, the only outcome reported here is a clinical withdrawal rating at 1 and 24 hours after the rapid detox procedure in 40 subjects, 70% of whom were dependent on heroin and/or methadone.  It is not clear if they were consecutive or chosen in another manner, 'retrospectively'.  Seventy five percent of subjects were Caucasian with the remaining 25% Asian.  


  In this seven page article, the 'results' section takes eight lines, using the somewhat clumsy wording: "The average [withdrawal score] for the group supports lowered symptoms over a 24-hour period.  For 5 out of 40 patients this was not the case, that is, their change scores were negative, which indicated increased withdrawal symptoms".  So, as well as for some whose symptoms became worse over 24 hours, another proportion would have had no significant change in withdrawal ratings, yet these are lumped with the former 35 of 40 subjects given the procedure.  It is disappointing that the authors do not apparently trust readers with the raw data, even in a graphic form, giving only a block table of averaged scores.  


  Prospective patients, families and others may be disappointed that a novel, expensive treatment for a chronic condition is only examined for one single day in this publication.  It may reflect a prevalent view that some such facilities are less interested in the long term outcomes than in performing the procedure and 'moving on'.  This institution has done more than most by publishing a series of outcome findings in a peer reviewed journal.  


  I have looked up the institution on a web search and found two matches.  One quotes a figure of $5300.00 (Canadian) for a procedure [http://www.westerndetox.com/price.html accessed 16/7/05], while the FAQ site is 'under construction' which would be something of a disappointment for prospective addicted candidates [http://www.canadadetox.com/English/faq.asp accessed 16/7/05].   


  Another of the linked pages states "As it stands now, 6-8 out of 10 patients who are detoxed successfully will relapse in the first six months, back to their drug of choice. In an effort to dramatically improve those numbers, our centre encourages that all patients participate both in the Naltrexone Pellet Maintenance Program and a structured aftercare program conducted by an addiction specialist."  [Thus the suggested treatment will cost more if the naltrexone 'pellets' are chosen.]  


  Thus because the procedure has such a poor reported success rate, the clinic advises an untested and unregistered sub-cutaneous drug treatment as an optional 'add-on'.  


  Everyone in the field knows how earnestly many of our patients are seeking abstinence.  It may be this factor which clouds some people's judgment and fuels the use of expensive and unproven approaches.  The first unhappy reports of rapid detoxification for opiate addiction were from 1899 [MacLeod, N. Cure of morphine, chloral, and cocaine habits by sodium bromide. Brit Med Journ (1899) 15/4/1899 p896].  The procedure may well be appropriate for some candidates but until some selection criteria are reported with outcome results, we will remain in the dark.  


  comments by Andrew Byrne ..



     Dr Andrew Byrne MB BS (Syd) FAChAM (RACP)

     Dependency Medicine,

     75 Redfern Street, Redfern,

     New South Wales, 2016, Australia

     Email - ajbyrneATozemail.com.au

     Tel (61 - 2) 9319 5524  Fax 9318 0631



  Author of: "Addict in the Family" http://www.csdp.org/addict/  

  My grandfather Harry Gracie's letters from 1924 trip to Mayo Clinic:




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