Changes in Reduced Glutathione and Glutathione S-Transferase Concentration During Rapid Opioid Detoxification

Introduction. Oxidative stress causes damage to various organ systems in pa­tients dependent on opioids. The aim of the study is to measure plasma concen­tration of the glutathione S-transferase and reduced glutathione among heroin addicts during rapid opioid detoxifica­tion.

Material and methods. 58 pa­tients enrolled in this study, and they were divided into control and treat­ment groups consisting of 29 patients each. On the first and second days the patients in both groups received an identical treatment. From the third day, difierent modes of naltrexone ini duction were applied to the groups. Blood samples were taken 1 hour bei fore the start of naltrexone induction as well as 1, 5 and 23 hours after the in­duction.

Results. Given the spread of the tested parameter values, data was di­vided into two ranges: glutathione S-transferase concentration formed the range of the data values from 0.160 to 8 ng/ml, and from 8.769 to 23.863 ng/ml; reduced glutathione formed the range of the data values from 1.749 pg/ml to 4.888 pg/ml, and from 4.889 pg/ml to 10.079 pg/ml. Glutathione S-transferase concentra­tion in the treatment group at the range of data values from 0.160 to 8 ng/ml showed statistically significant reduction after 23 hours com­pared to glutathione S-transferase con­centration after 5 hours of naltrexone induction. In the control group, lower levels of glutathione S-transferase concentration were observed 1 hour and 23 hours after naltrexone induction. Reduced glutathione concentration was significantly lower only in the con­trol group 1 hour after naltrexone in­duction and remained lower compared to the starting level.

Conclusions. Glutathione S-transferase and reduced glutathione changes during rapid opioid detoxifica­tion are more pronounced while treat­ing patients with a normal single dose of naltrexone compared to gradual in­crease in naltrexone dosage.