Subjective Scoring Index Opiate Withdrawal during Naloxone Therapy

Protocol:

(1) An injection of a saline placebo is given initially.

(2) Increasing doses of naloxone are then administered at 10 minute intervals

(2a) 0.2 mg

(2b) 0.4 mg

(2c) 0.6 mg

(3) The signs and symptoms were measured at 1, 3 and 7 minutes after each dose.

(4) If severe withdrawal symptoms develop following an injection, then subsequent injections of the naloxone are stopped.

weighted score after each injection =

= SUM for all 9 signs or symptoms ((weighting) * (severity factor))

subjective scoring index =

= (maximum weighted score) / (total injected naloxone dose)

Interpretation:

• minimum weighted score: 0

• maximum weighted score: 14.25

• minimum SSI: 0

• maximum SSI: 11.88 after all 3 doses, 23.75 after 2 doses, 71.25 after only 1 dose

• The symptoms after the second naloxone dose correlates well with the final severity of the withdrawal.

• Physical signs correlating with severity of the withdrawal syndrome include hand tremor, trapezius EMG and heart rate.