The American journal of drug and alcohol abuse
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Am J Drug Alcohol Abuse · May 2012
Comparative StudyA comparison of attitudes toward opioid agonist treatment among short-term buprenorphine patients.
Obtaining data on attitudes toward buprenorphine and methadone of opioid-dependent individuals in the United States may help fashion approaches to increase treatment entry and improve patient outcomes. ⋯ These data contribute to our understanding of why people seek or do not seek effective pharmacotherapy for opioid addiction.
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Am J Drug Alcohol Abuse · May 2012
Randomized Controlled TrialThe combination very low-dose naltrexone-clonidine in the management of opioid withdrawal.
The management of withdrawal absorbs substantial clinical efforts in opioid dependence (OD). The real challenge lies in improving current pharmacotherapies. Although widely used, clonidine causes problematic adverse effects and does not alleviate important symptoms of opioid withdrawal, alone or in combination with the opioid antagonist naltrexone. Very low-dose naltrexone (VLNTX) has been shown to attenuate withdrawal intensity and noradrenaline release following opioid agonist taper, suggesting a combination with clonidine may result in improved safety and efficacy. ⋯ Preliminary results elucidate neurobiological mechanisms of OD and support the utility of controlled studies on a novel VLNTX + low-dose clonidine combination for the management of opioid withdrawal.
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Am J Drug Alcohol Abuse · May 2012
ReviewOpioid detoxification and naltrexone induction strategies: recommendations for clinical practice.
Opioid dependence is a significant public health problem associated with high risk for relapse if treatment is not ongoing. While maintenance on opioid agonists (i.e., methadone, buprenorphine) often produces favorable outcomes, detoxification followed by treatment with the μ-opioid receptor antagonist naltrexone may offer a potentially useful alternative to agonist maintenance for some patients. ⋯ Among the current detoxification regimens, the available clinical and scientific data suggest that the best approach may be using an initial 2-4 mg dose of buprenorphine combined with clonidine, other ancillary medications, and progressively increasing doses of oral naltrexone over 3-5 days up to the target dose of naltrexone. However, more research is needed to empirically validate the best approach for making this transition.
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Am J Drug Alcohol Abuse · May 2012
Comparative StudyA comparison of rural and urban nonmedical prescription opioid users' lifetime and recent drug use.
Nonmedical prescription opioid use has emerged as a major public health concern. The growing burden of nonmedical prescription opioid use in America may have unique manifestations and consequences in rural areas, which to a large extent have yet to be explored. ⋯ The findings demonstrate that, in this sample, nonmedical prescription opioid use is dissimilar among rural and urban drug users. Additional research is needed to better understand the individual, social, and structural level factors contributing to the burden of nonmedical opioid use, particularly in rural populations, with the aim of developing tailored substance abuse treatment and prevention.
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Am J Drug Alcohol Abuse · May 2012
Change in quality of life and its predictors in heroin users receiving methadone maintenance treatment in Taiwan: an 18-month follow-up study.
A good quality of life (QOL) is associated with successful treatment in patients with opioid dependence. Therefore, it is of clinical benefit to examine what factors can predict a change in QOL among heroin users in the course of a methadone maintenance treatment (MMT) program. ⋯ Efforts are needed to amend the modifiable factors related to poor QOL for heroin users in MMT programs.