1 A Study to Develop a Model for a Community Detoxification Team using

This study was prompted by the growing interest in and demand for non-opiate alternatives to methadone detoxification, such as the 2-adrenergic agonist lofexidine. Lofexidine acts centrally to suppress the opiate withdrawal syndrome and offers a non-opiate, rapid withdrawal treatment from opiates, without the risk of dependency. The study aims to identify an appropriate alternative model for a Community Detoxification Team for implementation in Clondalkin, an urban area where there are high levels of opiate misuse. The review of the relevant literature provided a conceptual and practical base of knowledge to inform the study. The review found that lofexidine can be used safely in a community stetting and therefore could provide a viable, safe alternative to methadone. Qualitative research techniques were employed to illicit key informants ’ experiences and views of lofexidine detoxification. 20 people participated in two focus groups, while 11 participated in individual semi-structured interviews. Interviews were transcribed and analysis aided by the use of the Nud*ist 4 software package. The findings of this study support the need for the provision of alternative treatment options to drug misuser. In general, lofexidine was found to be suitable mainly for younger users with a short history of opiate dependence. Motivation, family and social supports together with the availability of counselling were identified as important factors in determining a positive outcome from lofexidine detoxification. The study recommends that a Community Detoxification Team, using lofexidine, be established on a pilot basis. The team should consist of a Co-ordinator, Drugs Worker, Nurse and General Practitioner. It is proposed that the community detoxification programme will take place over a four-week period and an integrated care pathway has been identified. Areas of further research were also discussed