Table of Contents

Full Contents 1. Executive summary * General considerations * Assessment * Pharmacological interventions in opioid detoxification * Opioid detoxification in community, residential, inpatient and prison settings * Specific psychosocial interventions * Research recommendations 2. Introduction * National guidelines * The national opioid detoxification for drug misuse guideline 3. Introduction to drug misuse * Drug misuse and opioid dependence * Epidemiology of drug misuse * Aetiology and maintenance of drug misuse * The course of drug misuse * The pharmacology of opioids * The public health impact of drug misuse * Identification and assessment of drug misuse * The aims of the treatment and management of drug misuse * The development of detoxification services * Current care and treatment in the NHS * The experience of drug misuse - personal perspectives * Impact of drug misuse on families and carers * Economic impact of drug misuse 4. Methods used to develop this guideline * Overview * The scope * The Guideline Development Group * Clinical questions * Systematic clinical literature review * Systematic economic literature review * Stakeholder contributions * Validation of this guideline 5. Assessment and testing * Introduction * Clinical assessment in the management of detoxification * Drug testing * Psychometric assessment tools 6. Pharmacological and physical interventions in opioid detoxification * Introduction * Pharmacological interventions in detoxification * Overall clinical summary of pharmacological interventions in detoxification * Clinical practice recommendations * Ultra-rapid, rapid and accelerated detoxification using opioid antagonists * Clinical practice recommendations * Physical and complementary interventions during detoxification 7. Psychosocial interventions in opioid detoxification * Introduction * Current practice * Definitions * Outcomes * Databases searched and inclusion/exclusion criteria * Studies considered * Psychosocial interventions in combination with detoxification * Clinical summary * Literature review of health economics evidence * Economic modelling * Clinical practice recommendations 8. Settings for opioid detoxification * Introduction * Inpatient and community-based settings * Unassisted/self-detoxification * Prison-based detoxification 9. Appendices 10. Glossary 11. References 12. Abbreviations

About the Author

The National Collaborating Centre for Mental Health (NCCMH) was established in 2001 by the UK-based National Institute for Health and Clinical Excellence (NICE) to develop guidance on the appropriate treatment and care of people with mental health problems and then write the clinical guidelines. The NCCMH is a partnership between the Royal College of Psychiatrists and the British Psychological Society.