In-patient detoxification program with codeine is one of the alternatives for patients with opioid dependence. It consists of three principal components: pharmacotherapy, psychotherapy and therapeutic regime. The information about the procedure and experience from the implementation of the program in CPLDZ was the aim of the study. The Studied sample of 212 subjects was formed from a group of 589 patients from the years 1999-2001. 82 % were males with an average age 23.6 years, median 23.0 (18 – 43). The Himmelsbach scale was used to assess the objective symptoms of withdrawal during the short 14-day period of detoxification. The overall retention rate was 63 %, while 59 % in the studied group (statistically non significant). There was a relatively low level of distress according to the occurrence of objective and subjective symptoms of withdrawal. Signs of mild and moderate degrees of withdrawal were present on the Himmelsbach scale with relatively low frequency, the most pronounced during the first three days. Perspiration was the most frequent in 18 % of patients on the 2nd day, muscle tremor (13 %), anorexia (11 %), gooseflesh (10 %), and lacrimation (8 %). A significant decline in the occurrence of objective symptoms was observed from day 4 with a slight increase on day 9 and 10. It was similar with the most frequent subjective symptoms such as irritability, joint and muscle pain, which occurred among 11 %, 8 % and 5 % of patients on the 2nd day and among 10 % , 8 % and 8 % of patients at its second peak on day 9. Codeine phosphate seems to be an appropriate medication in combination with others, which can be used in short term, in-patient detoxification for patients with dependence on opioids, but mostly in conjunction with adequately chosen psychotherapy and within a structured treatment regime.

Key words: evaluation – opiate detoxification – codeine – Himmelsbach – retention rate – distress