Pharmacotherapies for the Treatment of Opioid Dependence: Efficacy, Cost-Effectiveness and Implementation Guidelines

by Mattick; Richard P.

• ISBN13: 9781841844008
• ISBN10: 1841844004
• Edition: 1st
• Format: Nonspecific Binding
• Copyright: 2009-03-25
• Publisher: CRC Press

Summary

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: A? detailed information on the cost-effectiveness of the various types of opioid treatment A? the range of pharmacotherapies used for the management of opioid dependence A? 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 asmethadone, 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.

Table of Contents

List of contributors	p. viii
Foreword	p. xi
Acknowledgments	p. xiv
Introduction
Opioid Dependence and Management	p. 1
Pharmacology of opioid agonists and antagonists	p. 15
Outcomes for Withdrawal
Services for heroin withdrawal: A review	p. 54
Outcomes for Maintenance Treatment
Methadone maintenance treatment	p. 107
LAAM in the treatment of opioid dependence: A systematic review	p. 142
The place of buprenorphine in the management of opioid dependence	p. 193
Treating heroin dependence with diamorphine (pharmaceutical heroin)	p. 227
Naltrexone maintenance treatment	p. 252
Outcomes from the National Evaluation of Pharmacotherapies for Opioid Dependence (NEPOD) Project
Pharmacotherapies and pregnancy	p. 282
Politics, practice, and research into treatment of heroin addiction	p. 330
Clinical guidelines and procedures for the use of methadone in the maintenance treatment of opioid dependence	p. 354
National clinical guidelines and procedures for the use of buprenorphine in the treatment of heroin dependence	p. 390
Clinical guidelines and procedures for the use of naltrexone in the management of opioid dependence	p. 446
Choosing treatments: The role of economics in informing future decisions	p. 475
Index	p. 489
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