美沙酮、丁丙诺啡、可乐定、纳曲酮“阶梯式”疗法治疗海洛因依赖脱毒后复吸患者33例

采用美沙酮、丁丙诺啡、可乐定、纳曲酮为主药的“阶梯式戒毒疗法”，治疗３３例戒毒后屡次复吸的海洛因依赖者。成功戒断８例，已操守０．５ａ以上，停服纳曲酮２个月以上；仍在服纳曲酮１６例，已分别服用１－４个月，操守率７２．７％；失败９例，其中服纳曲酮１－２个月后又复吸海洛因４例，治疗中失去联系而脱试３例，服纳曲酮１次后，戒断症状重而中止，改为自然康复２例，失败率２７．３％；配合心理疏导，有显著抗复吸作用，心理依赖降低，戒毒效果良好。

GRADIENT DETOXIFICATION OF 33 HEROIN ADDICTS BY METHADONE, BUPRENORPHINE, CLONIDINE AND NALTREXONE

heroin addicts who had detoxification treatment and relapsed several times were treated through a method of gradient detoxification with methadone, buprenorphine, clonidine and naltrexone. Of the 33 cases, 8 cases were successfully detoxified with a period of more than 6-month abstention, and did not take naltrexone for 2 months; 16 cases are still using naltrexone (with a period of 1-4 months); the abstention rate was 72.7%. 9 cases failed, including 4 cases who relapsed after adminis_ tering naltrexone for 1 to 2 months; 3 cases dropped out during treatment; 2 cases changed treatment method because of heavy withdrawal syndromes after taking naltrexone once; ineffective rate was 27.3%. The result showed that this method associated with pschological therapy could successfully reduce relapse rate, decrease psychological dependence and might be effective in heroin detoxification.