4 Research recommendations

The Guideline Development Group has made the following recommendations for research, based on its review of evidence, to improve NICE guidance and care of service users in the future.

4.1 Adjunctive medication during detoxification

If a person needs adjunctive medication during detoxification, in addition to their opioid agonist reducing regimen or in addition to an adjunctive alpha-2 adrenergic agonist (for example, lofexidine), what medications are associated with greater safety and fewer withdrawal symptoms?

Why this is important

A large variety of adjunctive medications are used for the management of withdrawal symptoms during detoxification, particularly when alpha-2 adrenergic agonists are used. Research is needed to guide decisions on how best to manage withdrawal symptoms with minimal risk of harm to the service user.

4.2 Comparing inpatient or residential and community detoxification

Is inpatient or residential detoxification associated with greater probability of abstinence, better rates of completion of treatment, lower levels of relapse and increased cost effectiveness than community detoxification?

Why this is important

There have been some studies comparing inpatient or residential detoxification with community detoxification. However, these studies are often based on small sample sizes, have considerable methodological problems and have produced inconsistent results. Inpatient or residential detoxification requires significantly more resources than community detoxification, so it is important to assess whether treatment in such settings is more clinically and cost effective. If so, it is also important to understand if there are particular subgroups that are more likely to benefit from treatment in these settings.

  • National Institute for Health and Care Excellence (NICE)