Correspondence  |   October 2003
Use of Anesthesia-assisted Detoxification in the Opioid-dependent Pain Patient
Author Notes
  • University of Toronto, Wasser Pain Management Centre, Mount Sinai Hospital, Toronto, Ontario.
Article Information
Correspondence   |   October 2003
Use of Anesthesia-assisted Detoxification in the Opioid-dependent Pain Patient
Anesthesiology 10 2003, Vol.99, 1030. doi:
Anesthesiology 10 2003, Vol.99, 1030. doi:
To the Editor:—
I read with interest the case report by Breitfield et al  , 1 in which the use of clonidine to reduce symptoms of opioid withdrawal is mentioned. It should be pointed out that clonidine is a μ2-adrenoceptor agonist, not an antagonist as reported in this article. 2 
The effectiveness of this technique for detoxification from opioid addiction remains controversial. Within the actively using opioid-addicted individual, this technique has been used to “reset” the opioid receptors in persons who have lost their sensitivity to illicit opioids, thus allowing them to use again. This results in a dramatic loss in opioid tolerance, which, in the context of illicit drug use can lead to fatal overdoses. Currently, detoxification of individuals addicted to opioids by this method is experimental and without a clearly favorable cost–benefit ratio. 3 
Breitfeld C, Eikermann M, Kienbaum P, Peters J: Opioid “holiday” following antagonist supported detoxification during general anesthesia improves opioid agonist response in a cancer patient with opioid addiction. A nesthesiology 2003; 98: 571–3Breitfeld, C Eikermann, M Kienbaum, P Peters, J
Kienbaum P, Heuter T, Michel MC, Scherbaum N, Gastpar M, Peters J: Sympathetic neural activation evoked by mu-receptor blockade in patients addicted to opioids is abolished by intravenous clonidine. A nesthesiology 2002; 96: 346–51Kienbaum, P Heuter, T Michel, MC Scherbaum, N Gastpar, M Peters, J
Gowing L, Ali R, White J: Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal [systematic review]. Cochrane Drugs and Alcohol Group Cochrane Database of Systematic Reviews 2002, issue 4