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The British Journal of Psychiatry 175: 158-162 (1999)
© 1999 The Royal College of Psychiatrists

Evaluation of the opioid addiction test in an out-patient drug dependency unit

AH Ghodse, JL Greaves and D Lynch
Department of Addictive Behaviour and Psychological Medicine, St George's Hospital Medical School, London.

BACKGROUND: The opioid addiction test is based on the measurement of pupil dilatation in opioid-dependent people in response to conjunctivally applied naloxone hydrochloride. A positive response (pupil dilatation) indicates that the subject is dependent on opioids. AIMS: To evaluate the test in an out-patient setting and to identify factors affecting its outcome. METHOD: Pupil size was measured using binocular pupillometry in 100 new patients attending an out-patient clinic for assessment and treatment of opioid use. Measurement was repeated 40 minutes after the unilateral instillation of naloxone drops into the conjunctival sac. RESULTS: We performed 127 tests, of which 103 (81.1%) were positive. Males, and those not on methadone at the time of the test, were more likely to have a negative test result. CONCLUSIONS: The opioid addiction test proved to be a very useful tool for the rapid diagnosis of opioid dependence in the out-patient clinic. Specialist pupillometric equipment increases the number of patients correctly identified as opioid-dependent on the first visit, but is not essential.




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Copyright © 1999 The Royal College of Psychiatrists.