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There are several variations of detoxification for patients with dependence on or addiction to opioids, or narcotics. These alternatives to conventional opioid detoxification include:

• Rapid detoxification. Patients are placed under general anesthesia. While unconscious, they are given intervenous injections of medications. Opiate blockers (e.g., naltrexone, naloxone), which halt the action of narcotics, are the most important of these. Medications that reduce withdrawal symptoms (e.g., muscle relaxants, anti-nausea medications) are also given. Rapid detoxification should be performed in an intensive care unit of a hospital. Because they are not conscious, patients generally feel none of the withdrawal symptoms.
  
  Using this method, detoxification occurs within four to eight hours. Patients are discharged once they have recovered from the anesthesia and physicians have made sure that they are not experiencing any complications. This usually occurs within 48 hours. Rapid detoxification is not for everyone, though. It is expensive and poses all the risks associated with general anesthesia, including death. It is best for patients who experience severe withdrawal symptoms or have failed conventional detoxification repeatedly.
  
  
• Stepped rapid detoxification. Here, patients are alert and in direct communication with the medical staff. About every hour, they are given small doses of naloxone injected just under the skin and naltrexone in pill form. They are also given medications for withdrawal symptoms as needed. Buprenorphine, a substitute medication, is often used for these. It is usually placed in tablet form under the tongue. This form of detoxification is slower than standard rapid detoxification but much faster than conventional detoxification. The pacing of the medications can be controlled in response to withdrawal symptoms. Because of this, there is less need for medications to manage these symptoms.
  
  
• Ultra rapid detoxification. Like rapid detoxification, patients in ultra rapid detoxification are placed under general anesthesia. They are given intravenous injections of naltrexone in elevated doses. Using this method, complete detoxification occurs within five to 30 minutes. However, ultra rapid detoxification can be painful despite the anesthesia. It is also expensive and poses all the risks associated with general anesthesia.
  

The general anesthesia required for rapid detoxification should only be administered by an anesthesiologist or a nurse anesthestist under the direct supervision of an anesthesiologist.

It is important to note that all forms of rapid detoxification are controversial and there is limited support for their use. There is no research that shows they are more likely to result in successful detoxification than more conservative modalities that do not pose the same risk of serious side effects.  Furthermore, rapid detoxification does not eliminate the need for the patient to enter a rehabilitation program to manage the psychosocial aspects of addiction