Addicts can "kick" habit while asleep - Your Life - use of "Ultrarapid opiate detoxification"

Not including the emotional and psychological costs, the economic expenses of drug and alcohol abuse in the U.S. are estimated to be at least $98,000,000,000 a year. For many who are addicted to heroin, a controversial, but effective, procedure could help them "kick" their habit. Ultrarapid opiate detoxification (UROD) has been used successfully in at least 10,000 cases worldwide. Considered a "critical care" procedure, UROD allows the addict to "go to sleep" under an anestheologist's care, avoid painful withdrawal, and regain consciousness well on the road to recovery. The procedure takes four to six hours, plus 24 hours of hospital monitoring, followed by several months of daily medications. The latter, called antagonists, block narcotics' effects, dramatically reducing users' compulsion to abuse drugs again.

According to research presented by Clifford M. Gevirtz to the American Society of Anesthesiologists, however, UROD can cause drastic physical changes in the patient and should only be done with an anesthesiologist present. Several cases done under lesser standards of care have had disastrous results. "There's routine anesthesia practice--and then there's this procedure, which involves many types of medications not normally used," Gevirtz, an anesthesiologist at Mount Sinai School of Medicine, New York, points out. "Only a trained medical specialist knows how to use these medications properly, and how to manage any complications."

Underscoring the need for an anesthesiologist to direct the procedure, Gevirtz cites analysis of the deaths of seven patients who underwent UROD. All seven procedures were performed by nurse anesthetists under the supervision of an internist. A complication known as pulmonary edema (fluid accumulation in the lungs) caused six of the deaths; pneumonia due to the aspiration of material from the stomach into the lungs, the seventh.

The ideal candidate for UROD has a powerful incentive--sometimes a financial one--to stop using, Gevirtz indicates. Although virtually every patient tries using drugs again after going through UROD, they quickly discover that they no longer get "high" when they use narcotics due to the antagonists' counter effects.

By removing the rewards of using drugs, the method offers an unusual opportunity to stop taking them. "UROD does not cure addiction, but it gives the individual a chance to start over, as long as the social environment that helped to support the addiction also goes away," Gevirtz concludes.

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