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Heroin Addiction and Related Clinical Problems: 2004, 06, 1 (pages: 35 - 42)
Payte T. J.
Summary: The motivation to develop a simple guideline for safe induction with methadone came largely from methadone-related deaths occuring during the induction phase of treatment. Clinical pearls for a safe induction are the following: 1) Very severe withdrawal signs/symptoms do not mean very high tolerance or the need for higher doses of methadone. 2) Consider use of instant opiate screens on admission with 2000 ng cut-off. 3) Document signs/symptoms of withdrawal with at least 2 objective signs. 4) Document daily assessment during induction includding basis for decisions to increase dose.
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