Detoxification from methadone maintenance: double-blind comparison of two methods.

A well-rehabilitated group of 22 methadone maintenance patients were detoxified under ambulatory and double-blind conditions, over 42 days, either by decreasing the daily dose of methadone and supplementing it by propoxyphene napsylate (M--PN), or by decreasing the daily dose of methadone administered in two equal doses given 12 hours apart (M--M). All of 12 (100%) M--M and 5 of 10 (50%) M--PN subjects were able to temporarily withdraw from methadone maintenance, although two of the M--PN patients required maintenance with propoxyphene napsylate to cease methadone maintenance. In our experience both detoxification methods employed appear superior to the standard withdrawal technique of simply reducing the daily methadone maintenance dose in a step-wise fashion.