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Guideline for Disease Management in Correctional Settings: Opioid Detoxification

NCJ Number
Date Published
October 2012
5 pages
This guideline provides best practices for dealing with inmates in acute opioid withdrawal.
This guideline provides information on best practices to address acute opioid withdrawal, an addiction affecting many inmates entering into correctional facilities. In the absence of systematic screening and assessment, acute opioid withdrawal often goes unrecognized and untreated. Untreated withdrawal results in needless suffering, potential interruption of life-sustaining medical treatments, such as HIV treatment, masked symptoms from other life-threatening illness, and, rarely, death. There are documented significant gaps in quality of care for opioid withdrawal in corrections, including underuse of recommended protocols and low use of drugs approved by the Food and Drug Administration (FDA) for detoxification. Topics addressed in this guideline included an introduction to the problem; best opioid detoxification practices in corrections, including universal screening, evaluation, detoxification, and referral for substance abuse treatment; substance abuse treatment; quality improvement measures; recommended resources to support evidence-based practice and quality improvement; DSM IV Criteria for Substance (Opioid) Dependence; and discussion on the advantages and limitations for use of buprenorphine, methadone, and clonidine for detoxification.; and a Clinical Opiate Withdrawal Scale. 2 tables and 1 figure