The most comprehensive text of its kind, this book addresses both the management of opioid withdrawal and opioid maintenance therapy, and combines up-to-date reviews of the scientific literature with evidence-based clinical guidelines for all of the relevant pharmacotherapies.
A unique work, Pharmacotherapies for the Treatment of Opioid Dependence presents:
* detailed information on the cost-effectiveness of the various types of opioid treatment
* the range of pharmacotherapies used for the management of opioid dependence
* the state of knowledge from the international research literature on the value and relative efficacy of the various pharmacological approaches.
This includes pharmacotherapies used in the management of withdrawal from opioids such as clonidine, lofexidine, methadone, buprenorphine and naltrexone and also symptomatic medications. It also includes different forms of maintenance therapy using opioid agonists such as methadone, LAAM, buprenorphine, slow-release oral morphine and diamorphine, and opioid antagonists such as naltrexone.
This text should appeal to researchers, to identify gaps in the research literature and provide a basis for determining appropriate research directionspolicy makers, to clinicians by providing clinical with clinical guidelines and information concerning the empirical basis for the treatments, and to policy makers in assisting them to make decisions about the various treatments from a public health perspective, taking into account the relative cost and effectiveness of the interventions.
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Section One: Introduction
1. Extent of Opioid Dependence and Management to Date
2. Pharmacology of Opioid Agonists and Antagonists
Section Two: Outcomes for Withdrawal
3. Management of Heroin Withdrawal
Section Three: Outcomes for Maintenance Treatment
4. Methadone Maintenance Treatment
5. LAAM Maintenance Treatment
6. Buprenorphine Maintenance Treatment
7. Other Forms of Opioid Agonist Maintenance Treatment
8. Naltrexone Maintenance/abstinence Orientated Therapy
Section Four: Outcomes from the National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) Project
9. Methodology of the NEPOD Project
10. The Relative Effectiveness of Withdrawal and Maintenance Treatments
11. Health Economic Methods and Outcomes
Section Five: Process Issues
12. Pharmacotherapies and Pregnancy
13. Adjuvant Psychosocial Interventions and Rehabilitation
14. Assessing Opioid Dependent Patients and Matching Them to Treatment
15. Models of Service Delivery
Section Six: Implementation Guidelines
16. Clinical Guidelines for Treatment with Methadone
17. Clinical Guidelines for Treatment with Buprenorphine
18. Clinical Guidelines for Treatment with LAAM
19. Clinical Guidelines for Treatment with Naltrexone
Section Seven: Conclusion
20. Future Directions
Richard P. Mattick is Director of Research, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia. Prof. Mattick is Executive Editor of journal Drug and Alcohol Review and is Assistant Editor of the journal Addiction (previously British Journal of Addiction).