Current and potential pharmacological treatment options for maintenance therapy in opioid-dependent individuals.
Current and potential pharmacological treatment options for maintenance therapy in opioid-dependent individuals.
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DOI：
10.2165/11597520-000000000-00000
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发表时间：
2012-01-22
期刊：
影响因子：
11.5
通讯作者：
Fiellin DA
中科院分区：
文献类型：
--
作者：
Tetrault JM;Fiellin DA
表现为对海洛因和药用类阿片成瘾的类阿片依赖正在增加。在国际上，估计有1，560万非法类阿片使用者。阿片类药物依赖的全球经济负担在艾滋病毒和丙型肝炎病毒传播、直接医疗保健费用以及通过犯罪活动、缺勤和生产力损失间接造成的经济负担方面都很沉重。阿片类激动剂药物，如美沙酮和丁丙诺啡，稳定神经系统和提供麻醉阻滞是最有效的治疗。与短期减量和停药相比，长期提供这些药物（定义为维持治疗）通常会改善结局。类阿片激动剂维持治疗的益处包括减少非法药物使用，改善治疗的持续性，减少艾滋病毒风险行为和减少犯罪行为。虽然各国的规定各不相同，但这些药物在国际上越来越容易获得，特别是在因注射吸毒而迅速传播艾滋病毒的地区。在这篇综述中，我们描述了阿片类药物依赖维持治疗的基本原理，讨论了阿片类药物拮抗剂如纳洛酮的新用途，以及纳洛酮和丁丙诺啡的缓释制剂，并提供了实验治疗的描述。
Opioid dependence, manifesting as addiction to heroin and pharmaceutical opioids is increasing. Internationally, there are an estimated 15.6 million illicit opioid users. The global economic burden of opioid dependence is profound both in terms of HIV and hepatitis C virus transmission, direct healthcare costs, and indirectly through criminal activity, absenteeism and lost productivity. Opioid agonist medications, such as methadone and buprenorphine, that stabilize neuronal systems and provide narcotic blockade are the most effective treatments. Prolonged provision of these medications, defined as maintenance treatment, typically produces improved outcomes when compared with short-duration tapers and withdrawal. The benefits of opioid agonist maintenance include decreased illicit drug use, improved retention in treatment, decreased HIV risk behaviours and decreased criminal behaviour. While regulations vary by country, these medications are becoming increasingly available internationally, especially in regions experiencing rapid transmission of HIV due to injection drug use. In this review, we describe the rationale for maintenance treatment of opioid dependence, discuss emerging uses of opioid antagonists such as naltrexone, and sustained-release formulations of naltrexone and buprenorphine, and provide a description of the experimental therapies.
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影响因子：
2.7
作者：
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