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Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal

Overview of attention for article published in Cochrane database of systematic reviews, January 2010
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About this Attention Score

  • In the top 25% of all research outputs scored by Altmetric
  • High Attention Score compared to outputs of the same age (89th percentile)
  • Above-average Attention Score compared to outputs of the same age and source (62nd percentile)

Mentioned by

blogs
2 blogs
wikipedia
1 Wikipedia page

Citations

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42 Dimensions

Readers on

mendeley
116 Mendeley
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Title
Opioid antagonists under heavy sedation or anaesthesia for opioid withdrawal
Published in
Cochrane database of systematic reviews, January 2010
DOI 10.1002/14651858.cd002022.pub3
Pubmed ID
Authors

Linda Gowing, Robert Ali, Jason M White

Abstract

Withdrawal (detoxification) is necessary prior to drug-free treatment or as the end point of long-term substitution treatment. To assess the effectiveness of opioid antagonists to induce opioid withdrawal with concomitant heavy sedation or anaesthesia, in terms of withdrawal signs and symptoms, completion of treatment and adverse effects. We searched the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2009), Medline (January 1966 to 11 August 2009), Embase (January 1985 to 2009 Week 32), PsycINFO (1967 to July 2009), and reference lists of articles. Controlled studies of antagonist-induced withdrawal under heavy sedation or anaesthesia in opioid-dependent participants compared with other approaches, or a different regime of anaesthesia-based antagonist-induced withdrawal. One reviewer assessed studies for inclusion, undertook data extraction and assessed quality. Inclusion decisions and the overall process were confirmed by consultation between all authors. Nine studies (eight randomised controlled trials) involving 1109 participants met the inclusion criteria for the review.Antagonist-induced withdrawal is more intense but less prolonged than withdrawal managed with reducing doses of methadone, and doses of naltrexone sufficient for blockade of opioid effects can be established significantly more quickly with antagonist-induced withdrawal than withdrawal managed with clonidine and symptomatic medications. The level of sedation does not affect the intensity and duration of withdrawal, although the duration of anaesthesia may influence withdrawal severity. There is a significantly greater risk of adverse events with heavy, compared to light, sedation (RR 3.21, 95% CI 1.13 to 9.12, P = 0.03) and probably with this approach compared to other forms of detoxification. Heavy sedation compared to light sedation does not confer additional benefits in terms of less severe withdrawal or increased rates of commencement on naltrexone maintenance treatment. Given that the adverse events are potentially life-threatening, the value of antagonist-induced withdrawal under heavy sedation or anaesthesia is not supported. The high cost of anaesthesia-based approaches, both in monetary terms and use of scarce intensive care resources, suggest that this form of treatment should not be pursued.

Mendeley readers

The data shown below were compiled from readership statistics for 116 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
United States 3 3%
United Kingdom 1 <1%
Switzerland 1 <1%
Unknown 111 96%

Demographic breakdown

Readers by professional status Count As %
Researcher 19 16%
Student > Master 17 15%
Student > Ph. D. Student 12 10%
Student > Bachelor 10 9%
Student > Doctoral Student 9 8%
Other 30 26%
Unknown 19 16%
Readers by discipline Count As %
Medicine and Dentistry 47 41%
Psychology 15 13%
Nursing and Health Professions 7 6%
Pharmacology, Toxicology and Pharmaceutical Science 7 6%
Social Sciences 6 5%
Other 13 11%
Unknown 21 18%

Attention Score in Context

This research output has an Altmetric Attention Score of 18. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 07 January 2020.
All research outputs
#1,107,507
of 15,383,358 outputs
Outputs from Cochrane database of systematic reviews
#3,089
of 11,171 outputs
Outputs of similar age
#27,541
of 265,906 outputs
Outputs of similar age from Cochrane database of systematic reviews
#67
of 181 outputs
Altmetric has tracked 15,383,358 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 92nd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 11,171 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 23.0. This one has gotten more attention than average, scoring higher than 72% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 265,906 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 89% of its contemporaries.
We're also able to compare this research output to 181 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 62% of its contemporaries.