Opioid dependence: Rationale for and efficacy of existing and new treatments

David A. Fiellin, Gerald H. Friedland, Marc Gourevitch

Research output: Contribution to journalReview article

Abstract

Opioid dependence is a chronic and relapsing medical disorder with a well-established neurobiological basis. Opioid agonist treatments, such as methadone and the recently approved buprenorphine, stabilize opioid receptors and the intracellular processes that lead to opioid withdrawal and craving. Both methadone and buprenorphine have been proven effective for the treatment of opioid dependence and can contribute to a decreased risk of human immunodeficiency virus (HIV) transmission. In addition, a buprenorphine/naloxone combination appears to have a decreased potential for abuse or diversion, compared with that associated with methadone. Largely because of these properties, recent legislation now affords an unprecedented opportunity for general physicians to offer opioid agonist treatment through their offices. This review focuses on the neurobiological basis of opioid dependence, the rationale for methadone and buprenorphine treatments, and issues in prescribing these medications to patients with HIV infection.

Original languageEnglish (US)
JournalClinical Infectious Diseases
Volume43
Issue numberSUPPL. 4
DOIs
StatePublished - Dec 15 2006

Fingerprint

Opioid Analgesics
Methadone
Buprenorphine
Therapeutics
HIV
Opioid Receptors
Virus Diseases
Legislation
Physicians

ASJC Scopus subject areas

  • Immunology

Cite this

Opioid dependence : Rationale for and efficacy of existing and new treatments. / Fiellin, David A.; Friedland, Gerald H.; Gourevitch, Marc.

In: Clinical Infectious Diseases, Vol. 43, No. SUPPL. 4, 15.12.2006.

Research output: Contribution to journalReview article

@article{1403b1ca99bb4f79b620d80d17a6fd6b,
title = "Opioid dependence: Rationale for and efficacy of existing and new treatments",
abstract = "Opioid dependence is a chronic and relapsing medical disorder with a well-established neurobiological basis. Opioid agonist treatments, such as methadone and the recently approved buprenorphine, stabilize opioid receptors and the intracellular processes that lead to opioid withdrawal and craving. Both methadone and buprenorphine have been proven effective for the treatment of opioid dependence and can contribute to a decreased risk of human immunodeficiency virus (HIV) transmission. In addition, a buprenorphine/naloxone combination appears to have a decreased potential for abuse or diversion, compared with that associated with methadone. Largely because of these properties, recent legislation now affords an unprecedented opportunity for general physicians to offer opioid agonist treatment through their offices. This review focuses on the neurobiological basis of opioid dependence, the rationale for methadone and buprenorphine treatments, and issues in prescribing these medications to patients with HIV infection.",
author = "Fiellin, {David A.} and Friedland, {Gerald H.} and Marc Gourevitch",
year = "2006",
month = "12",
day = "15",
doi = "10.1086/508180",
language = "English (US)",
volume = "43",
journal = "Clinical Infectious Diseases",
issn = "1058-4838",
publisher = "Oxford University Press",
number = "SUPPL. 4",

}

TY - JOUR

T1 - Opioid dependence

T2 - Rationale for and efficacy of existing and new treatments

AU - Fiellin, David A.

AU - Friedland, Gerald H.

AU - Gourevitch, Marc

PY - 2006/12/15

Y1 - 2006/12/15

N2 - Opioid dependence is a chronic and relapsing medical disorder with a well-established neurobiological basis. Opioid agonist treatments, such as methadone and the recently approved buprenorphine, stabilize opioid receptors and the intracellular processes that lead to opioid withdrawal and craving. Both methadone and buprenorphine have been proven effective for the treatment of opioid dependence and can contribute to a decreased risk of human immunodeficiency virus (HIV) transmission. In addition, a buprenorphine/naloxone combination appears to have a decreased potential for abuse or diversion, compared with that associated with methadone. Largely because of these properties, recent legislation now affords an unprecedented opportunity for general physicians to offer opioid agonist treatment through their offices. This review focuses on the neurobiological basis of opioid dependence, the rationale for methadone and buprenorphine treatments, and issues in prescribing these medications to patients with HIV infection.

AB - Opioid dependence is a chronic and relapsing medical disorder with a well-established neurobiological basis. Opioid agonist treatments, such as methadone and the recently approved buprenorphine, stabilize opioid receptors and the intracellular processes that lead to opioid withdrawal and craving. Both methadone and buprenorphine have been proven effective for the treatment of opioid dependence and can contribute to a decreased risk of human immunodeficiency virus (HIV) transmission. In addition, a buprenorphine/naloxone combination appears to have a decreased potential for abuse or diversion, compared with that associated with methadone. Largely because of these properties, recent legislation now affords an unprecedented opportunity for general physicians to offer opioid agonist treatment through their offices. This review focuses on the neurobiological basis of opioid dependence, the rationale for methadone and buprenorphine treatments, and issues in prescribing these medications to patients with HIV infection.

UR - http://www.scopus.com/inward/record.url?scp=33845411086&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33845411086&partnerID=8YFLogxK

U2 - 10.1086/508180

DO - 10.1086/508180

M3 - Review article

C2 - 17109303

AN - SCOPUS:33845411086

VL - 43

JO - Clinical Infectious Diseases

JF - Clinical Infectious Diseases

SN - 1058-4838

IS - SUPPL. 4

ER -