Table 1

 Five day detoxification programme

TimeMedicationPurpose
Afternoon day 1 through to midnight day 3Zuclopenthixol (Clopixol) 10 mg and diazepam (Valium) 10 mg orally, then zuclopenthixol 4×10 mg daily with another four doses as and if required and diazepam 4×10 mg daily. Trazodone hydrochloride 150–300 mg nightly.Sedation
Lorazepam (Ativan) up to 4 mg every 6 hours; chlorpromazine 50–100 mg every 6 hours for those with high tolerance to the standard medication, or where patients have been abusing benzodiazapines. Amylobarbitone/quinalbarbitone (Tiunal) 100 mg−200 mg every 6 hours if further top up neededAdditional medication if sedation not adequate
Day 4Challenge dose of oral 25 mg naltrexone (Nalorex)To flush out remaining opiates
Day 5Full naltrexone (Nalorex) dose (50 mg)To build block against opiate use
ThroughoutDiclofenac sodium (Voltarol); hyoscine butylbromide (Buscopan); ranitidine (Zantac); procyclidine (Kemadrin); prochlororperazine (Stemetil), metoclopramide (Maxolon) as required.To relieve symptoms or side effects of other medication