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20 - Treatment of opioid dependence

from Part III - Specific treatments

Published online by Cambridge University Press:  12 May 2010

By
Leslie L. Buckley ,
Nicholas Seivewright ,
Mark Parry ,
Abhijeetha Salvaji  and
Richard Schottenfeld
Edited by
Peter Tyrer  and
Kenneth R. Silk
Leslie L. Buckley
Affiliation:
University Health Network Toronto, ON Canada
Nicholas Seivewright
Affiliation:
Substance Misuse Service Fitzwilliam Centre Sheffield UK
Mark Parry
Affiliation:
Bowman House Reading Berkshire UK
Abhijeetha Salvaji
Affiliation:
Doncaster Drug Team Doncaster UK
Richard Schottenfeld
Affiliation:
Yale University School of Medicine Connecticut Mental Health Center New Haven, CT USA
Peter Tyrer
Affiliation:
Imperial College of Science, Technology and Medicine, London
Kenneth R. Silk
Affiliation:
University of Michigan, Ann Arbor
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Summary

Editor's note

Opiate addiction is one misuse and dependence disorder for which we have good pharmacological treatments. Both methadone and buprenorphine are effective in withdrawing individuals from opiates via substitution, and their use in maintenance treatment has an excellent track record. Naltrexone may also be efficacious for selected patients. Psychosocial and behavioral treatments play a role too, most often in combination with pharmacological treatments or for patients who do not want pharmacological treatments. This is one subject in which practice varies enormously in different parts of the world. Readers who look at the text closely will notice considerable geographical variation in treatment polices, and it is a tribute to our authors that they have kept this to a minimum in this combined chapter.

Introduction

Opioid dependence is a chronic disorder characterized by relapse, increased mortality, significant medical morbidity, psychiatric sequelae and impaired social function in the individual. Accompanying these detrimental effects to the dependent individual are costs to their families and society secondary to impaired social and occupational functioning and increased criminal behavior or violence. In recent years there have been considerable gains in our understanding of the neurobiology of opioid dependence and in the development of new pharmacological and behavioral treatments for opioid dependence.

Epidemiology

In 1999 there were estimated to be 1 million chronic users of heroin in the United States, or 0.4% (4 per 1000) of the population (Rhodes et al., 2000).

Type
Chapter
Information
Cambridge Textbook of Effective Treatments in Psychiatry , pp. 381 - 401
Publisher: Cambridge University Press
Print publication year: 2008

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References

Akram, G. (2000). Over-the-counter medcines: and emerging and neglected drug abuse?. Journal of Substance Use, 5, 136–42.Google Scholar
Amato, L., Davoli, M., Ferri, M., Gowing, L. & Perucci, C. A. (2004). Effectiveness of interventions on opiate withdrawal treatment: an overview of systematic reviews. Drug and Alcohol Dependence, 73, 219–26.Google Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV), 4th edn. Washington, DC: American Psychiatric Association.
Archie, C. (1998). Methadone in the management of narcotic addiction in pregnancy. Obstetrics and Gynecology, 10, 435–40.Google Scholar
Auriacombe, M., Franques, P., Daulouede, J. P. & Tignol, J. (1999). The French experience: results from extensive delimited research studies and nation-wide sample surveys. Research and Clinical Forums, 21, 9–15.Google Scholar
Avants, S. K., Margolin, A., Kosten, T. R., Rounsaville, B. J. & Schottenfeld, R. S. (1998). When is less treatment better? The role of social anxiety in matching methadone patients to psychosocial treatments. Journal of Consulting Clinical Psychology, 66(6), 924–31.Google Scholar
Avants, S. K., Margolin, A., Sindelar, J. L.et al. (1999). Day treatment versus enhanced standard methadone services for opioid-dependent patients: a comparison of clinical efficacy and cost. American Journal of Psychiatry, 156(1), 27–33.Google Scholar
Banbery, J., Wolff, K. & Raistrick, D. (2000). Dilhydrocodeine: a useful tool in the detoxification of methadone-maintained patients. Journal of Substance Abuse Treatment, 19, 301–5.Google Scholar
Barnett, P. G., Rodgers, J. H. & Bloch, D. A. (2001). A meta-analysis comparing buprenorphine to methadone for treatment of opiate dependence. Addiction, 96, 683–90.Google Scholar
Barrau, K., Thirion, X., Micallef, J., Chuniaud, L. C., Bellemin, B. & San-Marco, J. L. (2001). Comparison of methadone and high dosage buprenorphine users in French care centres. Addiction, 96, 1433–41.Google Scholar
Bates, M. & Pemberton, D. A. (1996). The effect of methadone prescribing in a clinic setting on the criminal activity of drug users. Scottish Medical Journal, 41, 173–5.Google Scholar
Battersby, M., Farrell, M., Gossop, M., Robson, P. & Strang, J. (1992). ‘Horse trading’: prescribing injectable opiates to opiates addicts. A descriptive study. Drug and Alcohol Review, 11, 35–42.Google Scholar
Bearn, J., Gossop, M. & Strang, J. (1996). Randomised double-blind comparison of lofexidine and methadone in the inpatient treatment of opiate withdrawal. Drug and Alcohol Dependence, 43, 87–91.Google Scholar
Bell, J., Mattick, R., Hay, A., Chan, J. & Hall, W. (1997). Methadone maintenance and drug-related crime. Journal of Substance Abuse, 9, 15–25.Google Scholar
Berghella, V., Lim, P. J., Hill, M. K., Cherpes, J., Chennat, J. & Kaltenbach, K. (2003). Maternal methadone dose and neonatal withdrawal. American Journal of Obstetrics and Gynecology, 189(2), 312–17.Google Scholar
Bertschy, G. (1995). Methadone maintenance treatment: an update. European Archives of Psychiatry and Clinical Neuroscience, 245, 114–24.Google Scholar
Beswick, T., Best, D., Bearn, J., Gossop, M., Rees, S. & Strang, J. (2003). The effectiveness of combined naloxone/lofexidine in opiate detoxification: results from a double-blind randomised and placebo-controlled trial. American Journal on Addictions, 12, 295–305.Google Scholar
Buster, M. C. A., Brussel, G. H. A. & Brink, W. (2002). An increase in overdose mortality during the first 2 weeks after entering or re-entering methadone treatment in Amsterdam. Addiction, 97, 993–1001.Google Scholar
Caplehorn, J. R., Dalton, M. S., Haldar, F., Petrenas, A. M. & Nisbet, J. G. (1996). Methadone maintenance and addicts' risk of fatal heroin overdose. Substance Use and Misuse, 31(2), 177–96.Google Scholar
Carnwath, T. & Hardman, J. (1998). Randomised double-blind comparison of lofexdine and clonidine in the out-patient treatment of opiate withdrawal. Drug and Alcohol Dependence, 50, 251–4.Google Scholar
Carreno, J. E., Alvarez, C. E., San Narciso, G. I., Bascaran, M. T., Diaz, M. & Bobes, J. (2003). Maintenance treatment with depot opioid antagonists in subcutaneous implants: an alternative in the treatment of opioid dependence. Addiction Biology, 8, 429–38.Google Scholar
Carroll, K. M., Ball, S. A., Nich, C.et al. (2001). Targeting behavioral therapies to enhance naltrexone treatment of opioid dependence: efficacy of contingency management and significant other involvement. Archives of General Psychiatry, 58(8), 755–61.Google Scholar
Carroll, K. M., Sinha, R., Nich, C., Babuscio, T. & Rounsaville, B. J. (2002). Contingency management to enhance naltrexone treatment of opioid dependence: a randomized clinical trial of reinforcement magnitude. Experimental Clinical Psychopharmacology, 10(1), 54–63.Google Scholar
Comer, S. D., Collins, E. D., Kleber, H. D., Nuwayser, E. S., Kerrigan, J. H. & Fischman, M. W. (2002). Depot naltrexone: long-lasting antagonism of the effects of heroin in humans. Psychopharmacology, 159, 351–60.Google Scholar
Corkery, J. M., Schifano, F., Ghodse, A. H. & Oyefeso, A.. (2004) The effects of methadone and its role in fatalities. Human Psychopharmacology, 19(8), 565–76.Google Scholar
Cornish, J. W., Metzger, D., Woody, G. E., et al. (1997). Naltrexone pharmacotherapy for opioid dependent federal probationers. Journal of Substance Abuse Treatment, 14(6), 529–34.Google Scholar
Croop, R. S., Faulkner, E. B. & Labriola, D. F. (1997). The safety profile of naltrexone in the treatment of alcoholism. Results from a multicenter usage study. The Naltrexone Usage Study Group in Archives of General Psychiatry, 54(12), 1130–5.Google Scholar
Curran, H. V., Bolton, J., Wanigaratne, S. & Smyth, C. (1999). Additional methadone increases craving for heroin: a double blind, placebo-controlled study of chronic opiate users receiving methadone substitution treatment. Addiction, 94, 665–74.Google Scholar
Davids, E. & Gastpar, M. (2004). Buprenorphine in the treatment of opioid dependence. European Neuropsychopharmacology, 14, 209–16.Google Scholar
Dawe, S., Griffiths, P., Gossop, M. & Strang, J. (1991). Should opiate addicts be involved in controlling their own detoxification? A comparison of fixed versus negotiable schedules. British Journal of Addiction, 86, 977–82.Google Scholar
Department of Health (1999). Drug Misuse and Dependence – Guidelines on Clinical Management. London: The Stationery Office.
Diamant, K., Fischer, G., Schneider, C.et al. (1998). Outpatient opiate detoxification treatment with buprenorphine. Preliminary investigation. European Addiction Research, 4, 198–202.Google Scholar
Dole, V. P., Robinson, J. W., Orraca, J., Towns, E., Searcy, P. & Caine, E. (1969). Methadone treatment of randomly selected criminal addicts. New England Journal of Medicine, 280, 1372–5.Google Scholar
Drug Addiction Treatment Act of 2000, Pub. L. No. 106–310 (October 17, 2000).
Eggen, A. E. & Andrew, M. (1994). Use of codeine analgesics in a general population. A Norwegian study of moderately strong analgesics. European Journal of Clinical Pharmacology, 46, 491–6.Google Scholar
Eklund, C., Melin, L., Hiltunen, A. J. & Borg, S. (1994). Detoxification from methadone maintenance treatment in Sweden: long-term outcome and effects on quality of life and life situation. The International Journal of the Addictions, 29, 627–45.Google Scholar
European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2000). Insights: reviewing current practice in drug-substitution treatment. Luxembourg: The European Union Office for Official Publications of the European Communities.
Faggiano, F., Vigna-Taglianti, F., Versino, E. & Lemma, P. (2003). Methadone maintenance at different dosages for opioid dependence. In Cochrane Database Systematic Review, 3, CD002208. Oxford: Update Software Ltd.Google Scholar
Fals-Stewart, W. & O'Farrell, T. J. (2003). Behavioral family counseling and naltrexone for male opioid-dependent patients. Journal of Consulting Clinical Psychology, 71(3), 432–42.Google Scholar
Farre, M., Mas, A., Torrens, M., Moreno, V. & Cami, J. (2002). Retention rate and illicit opioid use during methadone maintenance interventions: a meta-analysis. Drug and Alcohol Dependence, 65, 283–90.Google Scholar
Fiellin, D. A., O'Connor, P. G., Chawarski, M., Pakes, J. P., Pantalon, M. V. & Schottenfeld, R. S. (2001). Methadone maintenance in primary care: a randomized controlled trial. Journal of the American Medical Association, 286(14), 1724–31.Google Scholar
Fiellin, D. A., Pantalon, M. V., Pakes, J. P., O'Connor, P. G., Chawarski, M. & Schottenfeld, R. S. (2002). Treatment of heroin dependence with buprenorphine in primary care. American Journal of Drug and Alcohol Abuse, 28(2), 231–41.Google Scholar
Fischer, G., Gombas, W., Eder, H.et al. (1999). Buprenorphine versus methadone maintenance for the treatment of opioid dependence. Addiction, 94, 1337–47.Google Scholar
Galanter, M., Dermatis, H., Glickman, L.et al. (2004). Network therapy: decreased secondary opioid use during buprenorphine maintenance. Journal of Substance Abuse Treatment, 26(4), 313–18.Google Scholar
Alonso, Garcia F., Gutierrez, M., San, L.et al. (1989). A multicentre study to introduce naltrexone for opiate dependence in Spain. Drug and Alcohol Dependence, 23, 117–21.Google Scholar
Geerlings, P. J., Bos, T. W., Schalken, H. F. A. & Wouters, L. F. J. M. (1985). Detoxification of heroin addicts with electrostimulation or methadone. Tijdschrift voor Alcohol, Drugs en Andere Psychotrope Stoffen, 11, 80–5.Google Scholar
Gerra, G., Ferri, M., Polidori, E., Santoro, G., Zaimovic, A. & Sternieri, E. (2003). Long-term methadone maintenance effectiveness: psychosocial and pharmacological variables. Journal of Substance Abuse Treatment, 25, 1–8.Google Scholar
Giacomuzzi, S. M., Riemer, Y., Ertl, M.et al. (2003). Buprenorphine versus methadone maintenance treatment in an ambulant setting: a health-related quality of life assessment. Addiction, 98, 693–702.Google Scholar
Gilman, S. M., Galanter, M. & Dermatis, H. (2001). Methadone anonymous: a 12-step program for methadone maintained heroin addicts. Substance Abuse, 22(4), 247–56.Google Scholar
Gossop, M., Johns, A. & Green, L. (1986). Opiate withdrawal: inpatient versus outpatient programmes and preferred versus random assignment to treatment. British Medical Journal, 293, 103–4.Google Scholar
Gossop, M., Marsden, J., Stewart, D. & Rolfe, A. (2000). Patterns of improvement after methadone treatment: one year follow-up results from the National Treatment Outcome Research Study (NTORS). Drug and Alcohol Dependence, 60, 275–86.Google Scholar
Gossop, M., Marsden, J., Stewart, D. & Treacy, S. (2001). Outcomes after methadone maintenance and methadone reduction treatments: two-year follow-up results from the National Treatment Outcome Research Study. Drug and Alcohol Dependence, 62, 255–64.Google Scholar
Gossop, M., Marsden, J., Stewart, D. & Kidd, T. (2003) The National Treatment Outcome Research Study (NTORS): 4–5 year follow-up results. Addiction, 98, 291–303.Google Scholar
Gowing, L., Ali, R. & White, J. (2001). Opioid antagonists under sedation or anaesthesia for opioid withdrawal. Cochrane Database Systematic Reviews, 1, CD002022. Oxford: Update Software Ltd.Google Scholar
Guichard, A., Lert, F., Calderon, C.et al. (2003). Illicit drug use and injection practices among drug users on methadone and buprenorphine maintenance treatment in France. Addiction, 98, 1585–97.Google Scholar
Gunne, L. M. & Gronbaldh, L. (1981). The Swedish methadone maintenance program: a controlled study. Drug and Alcohol Dependence, 7, 249–56.Google Scholar
Gutierrez, M., Ballesteros, J., Gonzalez-Oliveros, R. & Apodaka, J. R. (1995). Retention rates in to naltrexone programmes for heroin addicts in Vitoria, Spain. European Psychiatry, 10, 183–8.Google Scholar
Hamilton, R. J., Olmedo, R. E., Shah, S.et al. (2002). Complications of ultrarapid opioid detoxification with subcutaneous naltrexone pellets. Academic Emergency Medicine, 9, 63–8.Google Scholar
Hatsukami, D. K. & Fischman, M. W. (1996). Crack cocaine and cocaine hydrochloride: are the differences myth or reality?. Journal of the American Medical Association, 276, 1580–8.Google Scholar
Herve, S., Riachi, G., Noblet, C.et al. (2004). Acute hepatitis due to buprenorphine administration. European Journal of Gastroenterology and Hepatology, 16(10), 1033–7.Google Scholar
Hiltunen, A. J. & Eklund, C. (2002). Withdrawal from methadone maintenance treatment. Reasons for not trying to quit methadone. European Addiction Research, 8, 38–44.Google Scholar
Howells, C., Allen, S., Gupta, J., Stillwell, G., Marsden, J. & Farrell, M. (2002). Prison based detoxification for opioid dependence: a randomised double blind controlled trial of lofexidine and methadone. Drug and Alcohol Dependence, 67, 169–76.Google Scholar
Hser, Y. I., Hoffman, V., Grella, C. E.et al. (2001). A 33-year follow-up of narcotic addicts. Archives of General Psychiatry, 58, 503–8.Google Scholar
Hulse, G. K. & Basso, M. R. (1999). Reassessing naltrexone maintenance as a treatment for illicit heroin users. Drug and Alcohol Review, 18, 263–9.Google Scholar
Iribarne, C., Dreano, Y., Bardou, L. G., Menez, J. F. & Berthou, F. (1997). Interaction of methadone with substrates of human hepatic cytochrome P450 3A4. Toxicology, 117(1), 13–23.Google Scholar
Johnson, R. E., Eissenberg, T., Stitzer, M. L., Strain, E. C., Liebson, I. A. & Bigelow, G. E. (1995). A placebo controlled clinical trial of buprenorphine as a treatment for opioid dependence. Drug and Alcohol Dependence, 40, 17–25.Google Scholar
Johnson, R. E., Chutuape, M. A., Strain, E. C., Walsh, S. L., Stitzer, M. L. & Bigelow, G. E. (2000). A comparison of levomethadyl acetate, buprenorphine, and methadone for opioid dependence. New England Journal of Medcine, 343(18), 1290–7.Google Scholar
Johnston, L. D., O'Malley, P. M., Bachman, J. G. & Schulenberg, J. E. (2004). Monitoring the Future National Results on Adolescent Drug Use: Overview of Key Findings, 2003 (NIH Publication No. 04–5506). Bethesda, MD: National Institute on Drug Abuse, 59 pp.
Justo, D., Gal-Oz, A., Paran, Y.et al. (2006). Methadone-associated Torsades de Pointes (polymorphic ventricular tachycardia) in opioid-dependent patients. Addiction, 101, 1333–8.Google Scholar
Kahn, A., Mumford, J. P., Ash-Rogers, G. & Beckford, H. (1997). Double-blind study of lofexidine and clonidine in the detoxification of opiate addicts. Drug and Alcohol Dependence, 44, 57–61.Google Scholar
Kakko, J., Svanborg, K. D., Kreek, M. J. & Heilig, M. (2003). 1-year retention and social function after buprenorphine-assisted relapse prevention treatment for heroin dependence in Sweden: a randomised, placebo-controlled trial. Lancet, 361, 662–8.Google Scholar
Keen, J., Oliver, P., Rowse, G. & Mathers, N. (2003). Does methadone maintenance treatment based on the new national guidelines work in a primary care setting?. British Journal of General Practice, 53, 461–7.Google Scholar
King, V. L., Stoller, K. B., Hayes, M.et al. (2002). A multicenter randomized evaluation of methadone medical maintenance. Drug and Alcohol Dependence, 65(2), 137–48.Google Scholar
Kirchmayer, U., Davoli, M., Verster, A. D., Amato, L., Ferri, M. & Perucci, C. A. (2002). A systematic review on the efficacy of naltrexone maintenance treatment in opioid dependence. Addiction, 97, 1241–9.Google Scholar
Kleber, H. D. (1998). Ultrarapid opiate detoxification. Addiction, 92, 1929–33.Google Scholar
Kornick, C. A., Kilborn, M. J., Santiago-Palma, J.et al. (2003). QTc interval prolongation associated with intravenous methadone. Pain, 105(3), 499–506.Google Scholar
Kosten, T. R. (2003). Buprenorphine for opioid detoxification: a brief review. Addictive Disorders and Their Treatment, 2, 107–12.Google Scholar
Kraft, M. K., Rothbard, A. B., Hadley, T. R., McLellan, A. T. & Asch, D. A. (1997). Are supplementary services provided during methadone maintenance really cost-effective?. American Journal of Psychiatry, 154(9), 1214–19.Google Scholar
Kraigher, D., Ortner, R., Eder, H., Schindler, S. & Fischer, G. (2002). Slow-release morphine hydrochloride for maintenance therapy of opioid dependence. Wiener Klinische Wochenschrift, 114, 904–10.Google Scholar
Krantz, M. J., Kutinsky, I. B., Robertson, A. D. & Mehler, P. S. (2003). Dose-related effects of methadone on QT prolongation in a series of patients with torsade de pointes. Pharmacotherapy, 23(6), 802–5.Google Scholar
Kraus, L., Augustin, R., Frischer, M., Kummler, P., Uhl, A. & Wiessing, L. (2003). Estimating prevalence of problem drug use at national level in countries of the European Union and Norway. Addiction, 98, 471–85.Google Scholar
Krupitsky, E. M., Zvartau, E. E., Masalov, D. V.et al. (2004). Naltrexone for heroin dependence treatment in St. Petersburg, Russia. Journal of Substance Abuse Treatment, 26(4), 285–94.Google Scholar
Kuschel, C. A., Austerberry, L., Cornwell, M., Couch, R. & Rowley, R. S. (2004). Can methadone concentrations predict the severity of withdrawal in infants at risk of neonatal abstinence syndrome?. Archives of Diseases Child and Fetal Neonatal Education, 89(5), F390–3.Google Scholar
Lacroix, I., Berrebi, A., Chaumerliac, C., Lapeyre-Mestre, M., Montastruc, J. L. & Damase-Michel, C. (2004). Buprenorphine in pregnant opioid-dependent women: first results of a prospective study. Addiction, 99, 209–14.Google Scholar
Langrod, J., Lowinson, J. & Ruiz, P. (1981). Methadone treatment and physical complaints: a clinical analysis. International Journal of Addiction, 16(5), 947–52.Google Scholar
Ling, W. & Wesson, D. R. (2003). Clinical efficacy of buprenorphine: comparisons to methadone and placebo. Drug and Alcohol Dependence, 70(2 Suppl), S49–57.Google Scholar
Ling, W., Wesson, D. R., Charuvastra, C. & Klett, C. J. (1996). A controlled trial comparing buprenorphine and methadone maintenance in opioid dependence. Archives of General Psychiatry, 53, 401–7.Google Scholar
MacLeod, J., Whittaker, A. & Robertson, J. R. (1998). Changes in opiate treatment during attendance at a community drug service: findings from a clinical audit. Drug and Alcohol Review, 17, 19–25.Google Scholar
Magura, S., Nwakeze, P. C., Kang, S. Y., & Demsky, S. (1999). Program quality effects on patient outcomes during methadone maintenance: a study of 17 clinics. Substance Use and Misuse, 34(9), 1299–324.Google Scholar
Marsch, L. A. (1998). The efficacy of methadone maintenance interventions in reducing illicit opiate use, HIV risk behaviour and criminality: a meta-analysis. Addiction, 93, 515–32.Google Scholar
Masson, C. L., Barnett, P. G., Sees, K. L.et al. (2004). Cost and cost-effectiveness of standard methadone maintenance treatment compared to enriched 180-day methadone detoxification. Addiction, 99(6), 718–26.Google Scholar
Matheson, C., Pitcairn, J., Bond, C. M., Teijlingen, E. & Ryan, M. (2003). General practice management of illicit drug users in Scotland: a national survey. Addiction, 98, 119–26.Google Scholar
Mattick, R. P., Breen, C., Kimber, J. & Davoli, M. (2002a). Methadone maintenance therapy versus no opioid replacement therapy for opioid dependence. Cochrane Database Systematic Reviews, 4, CD002209. Oxford: Update Software Ltd.Google Scholar
Mattick, R. P., Kimber, J., Breen, C. & Davoli, M. (2002b). Buprenorphine maintenance versus placebo or methadone maintenance for opioid dependence. Cochrane Database Systematic Reviews, 4. Oxford: Update Software Ltd.Google Scholar
McGregor, C., Ali, R., White, J. M.et al. (2002). A comparison of antagonist-precipitated withdrawal under anesthesia to standard inpatient withdrawal as a precursor to maintenance naltrexone treatment in heroin users: outcomes at 6 and 12 months. Drug and Alcohol Dependence, 68, 5–14.Google Scholar
McLellan, A. T., Arndt, I. O., Metzger, D. S., Woody, G. E. & O'Brien, C. P. (1993). The effects of psychosocial services in substance abuse treatment. Journal of the American Medical Association, 269(15), 1953–9.Google Scholar
Merrill, J., Alterman, A., Cacciola, J. & Rutherford, M. (1999). Prior treatment history and its impact on criminal recidivism. Journal of Substance Abuse Treatment, 17, 313–19.Google Scholar
Metrebian, N., Shanahan, W., Wells, B. & Stimson, G. V. (1998). Feasibility of prescribing injectable heroin and methadone to opiate dependent drug users: associated health gains and harm reductions. Medical Journal of Australia, 168, 596–600.Google Scholar
Metrebian, N., Shanahan, W., Stimson, G. V.et al. (2001). Prescribing drug of choice to opiate dependent drug users: a comparison of clients receiving heroin with those receiving injectable methadone at a West London drug clinic. Drug and Alcohol Review, 20, 267–76.Google Scholar
Metrebian, N., Carnwath, T., Stimson, G. V. & Storz, T. (2002). Survey of doctors prescribing diamorphine (heroin) to opiate-dependent drug users in the United Kingdom. Addiction, 97, 1155–61.Google Scholar
Metzger, D. S., Woody, G. E., McLellan, A. T.et al. (1993). Human immunodeficiency virus seroconversion among intravenous drug users in- and out-of-treatment: an 18 month prospective follow-up. Journal of Acquired Immune Deficiency Syndrome, 6, 1049–56.Google Scholar
Miller, W. R. & Rollnick, S. (1991). Motivational Interviewing: Preparing People for Change, 2nd edn. New York: Guilford Press.
Montoya, I. D., Gorelick, D. A., Preston, K. L.et al. (2004). Randomized trial of buprenorphine for treatment of concurrent opiate and cocaine dependence. Clinical and Pharmacological Therapy, 75(1), 34–48.Google Scholar
Newman, R. G. & Whitehill, W. B. (1979). Double-blind comparison of methadone and placebo maintenance treatments of narcotic addicts in Hong Kong. Lancet, 2, 485–8.Google Scholar
Nyswander, M., Winick, C., Bernstein, A., Brill, L. & Kaufer, G. (1958). Treatment of the narcotic addict: workshop, 1957. 1. The treatment of drug addicts as voluntary outpatients; a progress report. American Journal of Orthopsychiatry, 28(4), 714–27; discussion 727–9.Google Scholar
O'Connor, P. G. & Kosten, T. R. (1998). Rapid and ultrarapid opioid detoxification techniques. Journal of the American Medical Association, 279, 229–234.Google Scholar
O'Connor, P. G., Oliveto, A. H., Shi, J. M.et al. (1998). A randomized trial of buprenorphine maintenance for heroin dependence in a primary care clinic for substance users versus a methadone clinic. American Journal of Medicine, 105(2), 100–5.Google Scholar
O'Malley, J. E., Anderson, W. H. & Lazare, A. (1972). Failure of outpatient treatment of drug abuse. I. Heroin. American Journal of Psychiatry, 128(7), 865–8.Google Scholar
O'Malley, S. S., Jaffe, A. J., Chang, G., Schottenfeld, R. S., Meyer, R. E. & Rounsaville, B. (1992). Naltrexone and coping skills therapy for alcohol dependence: a controlled study. Archives of General Psychiatry, 49, 881–7.Google Scholar
Pates, R., McBride, A., Li, S. & Ramadan, R. (2002). Misuse of over-the-counter medicines: a survey of community pharmacies in a South Wales health authority. The Pharmaceutical Journal, 268, 179–82.Google Scholar
Petitjean, S., Stohler, R., D-glon, J.et al. (2001). Double-blind randomised trial of buprenorphine and methadone in opiate dependence. Drug and Alcohol Dependence, 62, 97–104.Google Scholar
Poirier, M. F., Laqueille, X., Jalfre, V.et al. (2004). Clinical profile of responders to buprenorphine as a substitution treatment in heroin addicts: results of a multicentre study of 73 patients. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 28, 267–72.Google Scholar
Preston, K. L., Silverman, K., Umbricht, A., DeJesus, A., Montoya, I. D., & Schuster, C. R. (1999). Improvement in naltrexone treatment compliance with contingency management. Drug Alcohol Dependence, 54(2), 127–35.Google Scholar
Ravndal, E. (2001). An outcome study of a therapeutic community based in the community: a five-year prospective study of drug abusers in Norway In Therapeutic Communities, 4th edn. Rawlings, B. & Yates, R., pp. 224–240. Philadelphia: Jessica Kingsley Publishers.
Ravndal, E. & Vaglum, P. (1991). Psychopathology and substance abuse as predictors of program completion in a therapeutic community for drug abusers: a prospective study. Acta Psychiatrica Scandinavica, 83, 217–22.Google Scholar
Rehm, J., Gschwend, P., Steffen, T., Gutzwiller, F., Dobler-Mikola, A. & Uchtenhagen, A. (2001). Feasibility, safety and efficacy of injectable heroin prescription for refractory opioid addicts: a follow-up study. Lancet, 358, 1417–20.Google Scholar
Rhodes, W., Layne, M., Johnston, P., & Hozik, L. (2000). What America's Users Spend on Illegal Drugs, 1988–1998. Office of National Drug Control Policy.
Ribeaud, D. (2004). Long-term impacts of the Swiss heroin prescription trials on crime of treated heroin users. Journal of Drug Issues, 34, 163–94.Google Scholar
Riordan, C. E. & Kleber, H. D. (1980). Rapid opiate detoxification with clonidine and naloxone (letter). Lancet, 1(8177), 1079–80.Google Scholar
Roozen, H. G., Boulogne, J. J., Tulder, M. W., Brink, W. & Jong, C. A. J. (2004). A systematic review of the effectiveness of the community reinforcement approach in alcohol, cocaine and opioid addiction. Drug and Alcohol Dependence, 74, 1–13.Google Scholar
Roset, P., Farre, M., Torre, R.et al. (2001). Modulation of rate of onset and intensity of drug effects reduces abuse potential in healthy males. Drug Alcohol Dependence, 64, 285–98.Google Scholar
Roth, A., Hogan, I. & Farren, C. (1997). Naltrexone plus group therapy for the treatment of opiate-abusing health-care professionals. Journal of Substance Abuse Treatment, 14(1), 19–22.Google Scholar
Rounsaville, B. J. (1995). Can psychotherapy rescue naltrexone treatment of opioid addiction?. NIDA Research Monograph, 150, 37–52.Google Scholar
Rounsaville, B. J., Glazer, W., Wilber, C. H., Weissman, M. M. & Kleber, H. D. (1983). Short-term interpersonal psychotherapy in methadone-maintained opiate addicts. Archives of General Psychiatry, 40, 629–36.Google Scholar
Rothenberg, J. L., Sullivan, M. A., Church, S. H.et al. (2002). Behavioral naltrexone therapy: an integrated treatment for opiate dependence. Journal of Substance Abuse Treatment, 23(4), 351–60.Google Scholar
Salsitz, E. A., Joseph, H., Frank, B.et al. (2000). Methadone medical maintenance (MMM): treating chronic opioid dependence in private medical practice – a summary report (1983–1998). Mount Sinai Journal of Medicine, 67(5–6), 388–97.Google Scholar
San, L., Pomarol, G., Peri, J. M., Olle, J. M. & Cami, J. (1991). Follow-up after a 6-month maintenance period on naltrexone versus placebo in heroin addicts. British Journal of Addiction, 86, 983–90.Google Scholar
Saunders, B., Wilkinson, C. & Phillips, M. (1995). The impact of a brief motivational intervention with opiate users attending a methadone programme. Addiction, 90(3), 415–24.Google Scholar
Schindler, S. D., Eder, H., Ortner, K. R., Rohrmeister, K., Langer, M. & Fischer, G. (2003). Neonatal outcome following buprenorphine maintenance during conception and throughout pregnancy. Addiction, 98, 103–10.Google Scholar
Schottenfeld, R. S., Pakes, J. R., Oliveto, A., Ziedonis, D. & Kosten, T. R. (1997). Buprenorphine vs methadone maintenance treatment for concurrent opioid dependence and cocaine abuse. Archives in General Psychiatry, 54(8), 713–20.Google Scholar
Sees, K. L., Delucchi, K. L., Masson, C.et al. (2000). Methadone maintenance vs 180-day psychosocially enriched detoxification for treatment of opioid dependence: a randomized controlled trial. Journal of the American Medical Association, 283(10), 1303–10.Google Scholar
Seivewright, N. & Lagundoye, O. (2003). Withdrawal from methadone and methadone for withdrawal. In Methadone Matters: Evolving Community Methadone Treatment of Opioid Addiction, ed. Strang, J. & Tober, G., pp. 79–87. London: Martin Dunitz.
Sell, L., Segar, G. & Merrill, J. (2001). One hundred and twenty-five prescriptions for injectable opiates in the North West of England. Drug and Alcohol Review, 20, 57–66.Google Scholar
Sheppard, S. G. (1994). A preliminary investigation of ibogaine: Case reports and recommendations for further study. Journal of Substance Abuse Treatment, 11, 379–85.Google Scholar
Spear, H. B. (2002). Heroin Addiction Care and Control: The British System, 1916–1974, ed. Mott, J.. London: DrugScope.
Stanton, M. D., Todd, T. C. (1982). The Family Therapy of Drug Abuse and Addiction. New York: Guilford Press.
Stella, L., Cassese, F., Barone, S.et al. (1999). Naltrexone to keep a drug-free condition. Research Communications in Alcohol and Substance of Abuse, 20, 91–8.Google Scholar
Stitzer, M. L., Iguchi, M. Y. & Felch, L. J. (1992). Contingent take-home incentive: effects on drug use of methadone maintenance patients. Journal of Consulting Clinical Psychology, 60(6), 927–34.Google Scholar
Strain, E. C., Stitzer, M. L., Liebson, I. A. & Bigelow, G. E. (1994). Comparison of buprenorphine and methadone in the treatment of opioid dependence. American Journal of Psychiatry, 151, 1025–30.Google Scholar
Strain, E. C., Bigelow, G. E., Liebson, I. A. & Stitzer, M. L. (1999). Moderate- vs high-dose methadone in the treatment of opioid dependence: a randomized trial. Journal of the American Medical Association, 281, 1000–5.Google Scholar
Strang, J., Finch, E., Hankinson, L., Farrell, M., Taylor, C. & Gossop, M. (1997). Methadone treatment for opiate addiction: benefits in the first month. Addiction Research, 5, 71–6.Google Scholar
Strang, J., Marsden, J., Cummins, M.et al. (2000). Randomised trial of supervised injectable versus oral methadone maintenance: report of feasibility and 6-month outcome. Addiction, 95, 1631–45.Google Scholar
Substance Abuse and Mental Health Services Administration (SAMSHA). (2004). Overview of Findings from the 2003 National Survey on Drug Use and Health. Rockville, MD: NSDUH Series. Office of Applied Studies.
Ter-Riet, G., Kleijnen, J. & Knipschild, P. (1990). A meta-analysis of studies into the effect of acupuncture on addiction. British Journal of General Practice, 40, 379–82.Google Scholar
US Department of Justice, Drug Enforcement Administration: (2003). 2002 Domestic Monitor Program, Drug Intelligence Report. June, DEA-03057.
Uchtenhagen, A., Dobler-Mikola, A. & Gutzwiller, F. (1996). Medical prescription of narcotics: background and intermediate results of a Swiss national project. European Research Journal, 2, 201–7.Google Scholar
Uchtenhagen, A., Gutzweiller, F., Dobler-Mikola, A. & Steffen, A. (1997). A programme for a medical prescription of narcotics. A synthesis of results. European Addiction Research, 3, 160–16.Google Scholar
Uehlinger, C., Deglon, J. J., Livoti, S., Petitjean, S., Waldvogel, D. & Ladewig, D. (1998). Comparison of buprenorphine and methadone in the treatment of opioid dependence. Swiss multicentre study. European Addiction Research, 4, 13–18.Google Scholar
Brink, W., Hendriks, V. M., Blanken, P., Koeter, M. W. J., Zwieten, B. J. & Ree, J. M. (2003). Medial prescription of heroin to treatment resistant heroin addicts: two randomised controlled trials. British Medical Journal, 327, 310–12.Google Scholar
Verthein, U., Haasen, C. & Krausz, M. (2002). Auricular acupuncture as a treatment of cocaine, heroin and alcohol addiction: a pilot study. Addictive Disorders and Their Treatment, 1, 11–16.Google Scholar
Volpicelli, J. R.Alterman, A. I.Hayashida, M. & O'Brien, C. P. (1992). Naltrexone in the treatment of alcohol dependence. Archives of General Psychiatry, 49, 876–80.Google Scholar
Walsh, S. L. & Eissenberg, T. (2003). The clinical pharmacology of buprenorphine: extrapolating from the laboratory to the clinic. Drug and Alcohol Dependence, 70, S13–27.Google Scholar
Walsh, S. L., Strain, E. C. & Bigelow, G. E. (2003). Evaluation of the effects of lofexidine and clonidine on naloxone-precipitated withdrawal in opioid-dependent humans. Addiction, 98(4), 427–39.Google Scholar
Walsh, S. L., Preston, K. L., Stitzer, M. L., Cone, E. J. & Bigelow, G. E. (1994). Clinical pharmacology of buprenorphine: ceiling effects at high doses. Clinical and Pharmacological Therapy, 55(5), 569–80.Google Scholar
Washton, A. M., Gold, M. S. & Pottash, A. C. (1984). Successful use of naltrexone in addicted physicians and business executives. Advances in Alcohol Substance Abuse, 4(2), 89–96.Google Scholar
West, S. L., O' Neal, K. K. & Graham, C. W. (2000). A meta-analysis comparing the effectiveness of buprenorphine and methadone. Journal of Substance Abuse, 12, 405–14.Google Scholar
Williams, H., Remedios, A., Oyefeso, A. & Bennett, J. (2002). Buprenorphine detoxification treatment for heroin dependence: a preliminary experience in an outpatient setting. Irish Journal of Psychological Medicine, 19, 80–3.Google Scholar
Woody, G. E., Luborsky, L., McLellan, A. T.et al. (1983). Psychotherapy for opiate addicts. Does it help?. Archives in General Psychiatry, 40(6), 639–45.Google Scholar
Yandoli, D., Eisler, I., Robbins, C., Mulleady, G. & Dare, C. (2002). A comparative study of family therapy in the treatment of opiate users in a London drug clinic. Journal of Familiy Therapy, 24, 402–22.Google Scholar

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