Articles: narcotic-antagonists.
-
Methadone has been the mainstay of pharmacological management of opioid dependence since the 1960s but buprenorphine is fast gaining acceptance among addiction specialists and patients. This article provides an overview of buprenorphine, its pharmacology, clinical efficacy and role in the treatment of opioid dependence.
-
J Pain Symptom Manage · Nov 2007
Review Meta AnalysisPeripherally acting opioid antagonists in the treatment of opiate-related constipation: a systematic review.
Many patients treated with opioids suffer from constipation. Opiate- or opioid-related constipation is not only a frequent but also a distressing symptom and difficult to treat. There is emerging evidence regarding a novel approach to the management of opiate-related constipation. ⋯ Data show proof of concept but do not allow a definitive answer concerning the effectiveness of the peripherally acting micro-opioid antagonists methylnaltrexone and alvimopan in managing opiate-related constipation. Further research is needed. If future Phase III trials provide supportive data, opioid antagonists may become a standard therapeutic option for the treatment of opiate-related constipation in patients with advanced cancer.
-
Drug Alcohol Depend · Oct 2007
Implementation of buprenorphine in the Veterans Health Administration: results of the first 3 years.
Compared to non-veterans, veterans are disproportionately diagnosed with opioid dependence. Sublingual buprenorphine provides greater access to opioid agonist therapy. To understand the diffusion of this innovative treatment within a large healthcare system, we describe the introduction of buprenorphine within the Veterans Health Administration (VHA) during the first 3 years of its approval as a VHA non-formulary medication. ⋯ VHA increased, but not uniformly, the non-formulary use of office-based buprenorphine during the first 3 years of availability.
-
Testing oral fluid for drugs of abuse has been studied under many conditions but rarely has been evaluated in large population databases. We evaluated oral fluid tests in a database from a commercial laboratory in the United Kingdom composed of 8679 confirmed positive results. The results originated from 635,000 specimens collected over the period of May 2004 through September 2006. ⋯ The frequency of detection of 6-acetylmorphine when morphine was present (N = 4575 specimens) was 77.5%. Surprisingly, heroin (19.0%; N = 1091 specimens) and 6-acetylcodeine (24.9%; N = 1431 specimens) were frequently reported. The results from analysis of this large oral fluid database offer a rich mixture of new information on detection frequency, drug and metabolite patterns, and concentration data on drugs of abuse.
-
J Clin Psychopharmacol · Oct 2007
Comparative Study Clinical TrialEffectiveness of low-dose naltrexone in the post-detoxification treatment of opioid dependence.
The clinical use of naltrexone (NTX) in the treatment of opioid dependence has been limited because of poor compliance and inconsistent outcomes. In particular, the therapeutic benefit of extended treatment with NTX after opioid detoxification is unclear. The present study evaluated whether the augmentation with low-dose NTX during the post-detoxification treatment of opioid dependence would improve outcomes. ⋯ This preliminary study indicates the potential benefit of augmentation with low-dose NTX to improve outcomes after opioid detoxification for a preferred group of patients. Randomized controlled trials are necessary to further evaluate the role of low-dose NTX in the outpatient treatment of opioid dependence.