Drug and alcohol dependence
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Drug Alcohol Depend · Sep 1995
Randomized Controlled Trial Comparative Study Clinical TrialCurrent strategies for the treatment of alcohol dependence in the United States.
Substantial progress has been reported in the treatment of patients with alcoholism in the United States. Studies that seek to identify the most appropriate form of therapy for alcohol-dependent patients have been an important part of this effort. Recognition that psychotherapy alone cannot help all patients who have alcoholism has led to interest in the use of pharmacotherapy. Recent research demonstrates that pharmacotherapy with the opioid receptor antagonists naltrexone and nalmefene helps prevent relapse in many alcohol-dependent patients.
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Drug Alcohol Depend · Aug 1995
Clinical Trial Controlled Clinical TrialAssessment of nalmefene glucuronide as a selective gut opioid antagonist.
Opioid use often causes troublesome constipation as a side-effect. Selective antagonism of the intestinal actions of opioids might be useful in the treatment of opioid-induced constipation. ⋯ Oral nalmefene glucuronide precipitated symptoms and signs consistent with the opioid abstinence syndrome in all five subjects a mean of 9.0 h after dosing. We conclude that nalmefene glucuronide does not appear to exert sufficient gut selectivity to be useful in antagonizing constipation due to exogenous opioid administration without antagonizing systemic opioid effects.
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Drug Alcohol Depend · Oct 1994
ReviewBehavior in cocaine-exposed infants and children: association versus causality.
The effects of prenatal cocaine exposure on infant and child development and behavior are uncertain. This ambiguity has been enhanced by the early nature of human research and suboptimal study designs. Methodological difficulty in this research, particularly in the consideration of confounding effects, has made it difficult to ascribe causal relationships. Future research must consider more precise measures of confounding.
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Drug Alcohol Depend · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialOpiate detoxification of methadone maintenance patients using lefetamine, clonidine and buprenorphine.
Thirty-nine methadone maintenance patients were included in a 9-day, double blind, randomized, inpatient detoxification trial. Methadone was tapered to 10 mg/day and then patients were assigned to one of these 3 protocols: clonidine (0.3-0.9 mg/day), lefetamine (60-240 mg/day), buprenorphine (0.15-0.9 mg/day). ⋯ Clonidine was more effective than lefetamine in suppressing withdrawal in the first 3 days of treatment (day 3: F = 4.10 df = 2, 30 P < 0.05), and this trend was apparent on the objective and psychological items. In addition to evaluations of the efficacy of the single drugs used, the study showed that tapering methadone to low doses before entering the pharmacologically assisted discontinuation phase was clinically acceptable in detoxification from long-term methadone treatment.