role of verapamil in long-term management of opioid dependence

ABSTRACT

To determine the effectiveness of calcium channel blocker, verapamil in long-term management of patients with chronic dependence on opioids. Patients were admitted for 10 days in hospital. No treatment was given during first three days of admission after abrupt termination of opioid to observe the acute opioid withdrawal signs and symptoms. Then the verapamil was given orally to each patient in a dose 40 mg twice daily from day 4 to day 10 of admission. Then patients were discharged on the same treatment and advised to attend OPD weekly for further 12 weeks. The treatment was continued till the 8[th] week and then the dose of verapamil was gradually tapered off during next two weeks that is weeks 9 and 10. During last two weeks that is week 11 and 12 patients were assessed without given any treatment. The intensity of signs and symptoms were recorded by using objective opiate withdrawal scale and modified subjective opiate withdrawal scale respectively. The physiological parameters were also recorded throughout the study. Urine analysis for opioids was done on day 1 and day 10 of admission and then on 4[th], 8[th] and 12[th] weeks of follow up. Verapamil significantly decreased the intensity of signs and symptoms of protracted opioid withdrawal from day 4 to week 12. There were no undesirable variations in physiological parameters. Urine analysis for opioids was positive on day 1 while zero on day 10, weeks 4, 8 and 12. Verapamil significantly decreased the intensity of signs and symptoms of protracted opioid withdrawal during long-term management of opioid dependence