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Maintenance Medication for Opiate Addiction: The Foundation of Recovery
| Content Provider | Scilit |
|---|---|
| Author | Bart, Gavin |
| Copyright Year | 2012 |
| Description | Illicit use of opiates is the fastest growing substance use problem in the United States and the main reason for seeking addiction treatment services for illicit drug use throughout the world. It is associated with significant morbidity and mortality related to HIV, hepatitis C, and overdose. Treatment for opiate addiction requires long-term management. Behavioral interventions alone have extremely poor outcomes, with more than 80% of patients returning to drug use. Similarly poor results are seen with medication assisted detoxification. This article provides a topical review of the three medications approved by the FDA for long-term treatment of opiate dependence: the opioid agonist methadone, the opioid partial agonist buprenorphine, and the opioid antagonist naltrexone. Basic mechanisms of action and treatment outcomes are described for each medication. Results indicate that maintenance medication provides the best opportunity for patients to achieve recovery from opiate addiction. Extensive literature and systematic reviews show that maintenance treatment with either methadone or buprenorphine is associated with retention in treatment, reduction in illicit opiate use, decreased craving, and improved social function. Oral naltrexone is ineffective in treating opiate addiction but recent studies using extended release naltrexone injections have shown promise. While no direct comparisons between extended release naltrexone injections and either methadone or buprenorphine exist, indirect comparison of retention shows inferior outcome compared to methadone and buprenorphine. Further work is needed to compare directly each medication and determine individual factors that can assist in medication selection. Until such time, selection of medication should be based on informed choice following a discussion of outcomes, risks, and benefits of each medication. |
| Related Links | http://europepmc.org/articles/pmc3411273?pdf=render https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3411273/pdf |
| Ending Page | 225 |
| Page Count | 19 |
| Starting Page | 207 |
| ISSN | 10550887 |
| e-ISSN | 15450848 |
| DOI | 10.1080/10550887.2012.694598 |
| Journal | Journal of addictive diseases |
| Issue Number | 3 |
| Volume Number | 31 |
| Language | English |
| Publisher | Informa UK Limited |
| Publisher Date | 2012-07-01 |
| Access Restriction | Open |
| Subject Keyword | Journal: Journal of Addictive Diseases Substance Abuse Review Opiate Addiction Methadone Buprenorphine Naltrexone Pharmacotherapy |
| Content Type | Text |
| Resource Type | Article |
| Subject | Clinical Psychology Psychiatry and Mental Health |
