Treatment of Opioid Dependence

TY - CHAP

T1 - Treatment of Opioid Dependence

AU - Wolff, Kim

AU - Karch, Steven

AU - White, Jason

PY - 2016

Y1 - 2016

N2 - Many drug treatment services remain dominated by substitute prescribing programmes for heroin (diacetylmorphine) dependent individuals. It was estimated in 2007 that there were 15.6 million users of illicit opioids worldwide (United Nations Office on Drugs and Crime, 2007). Figures are not diminishing and the 2015 World Drug Report of the United Nations Office on Drugs and Crime (UNODC, 2015) estimates that a total of 246 million people - slightly over 5 per cent of those aged 15 to 64 years worldwide - used an illicit drug in 2013. Some 27 million people are problem drug users, almost half of whom are people who inject drugs (PWID). North America, Australia and most European countries have some form of methadone treatment for opioid dependence and depending on the size and history of the problem, a small or large percentage of the opioid dependent population will be in treatment. Current estimates record that there are about 306,150 opiate/cocaine users in England, of which 204,473 are in treatment and up to 70% of these receive methadone or other opioid substitution therapy (National Drug Treatment Monitoring System (NDTMS, 2010–11). In the period April 2011–March 2012 197,110 adults were in treatment contact with substance misuse services a third of these using opioids alone, with the remaining two-thirds combining it with cocaine (NDTMS statistics, 2012). Methadone maintenance treatment has been the most rapidly expanded treatment for heroin dependence over the last decade and it is being increasing described in countries that have been traditionally abstinence orientated such as China and the Middle East. Buprenorphine, a partial agonist has also become more prevalent as an alternative to methadone. Both compounds will be discussed in detail:

AB - Many drug treatment services remain dominated by substitute prescribing programmes for heroin (diacetylmorphine) dependent individuals. It was estimated in 2007 that there were 15.6 million users of illicit opioids worldwide (United Nations Office on Drugs and Crime, 2007). Figures are not diminishing and the 2015 World Drug Report of the United Nations Office on Drugs and Crime (UNODC, 2015) estimates that a total of 246 million people - slightly over 5 per cent of those aged 15 to 64 years worldwide - used an illicit drug in 2013. Some 27 million people are problem drug users, almost half of whom are people who inject drugs (PWID). North America, Australia and most European countries have some form of methadone treatment for opioid dependence and depending on the size and history of the problem, a small or large percentage of the opioid dependent population will be in treatment. Current estimates record that there are about 306,150 opiate/cocaine users in England, of which 204,473 are in treatment and up to 70% of these receive methadone or other opioid substitution therapy (National Drug Treatment Monitoring System (NDTMS, 2010–11). In the period April 2011–March 2012 197,110 adults were in treatment contact with substance misuse services a third of these using opioids alone, with the remaining two-thirds combining it with cocaine (NDTMS statistics, 2012). Methadone maintenance treatment has been the most rapidly expanded treatment for heroin dependence over the last decade and it is being increasing described in countries that have been traditionally abstinence orientated such as China and the Middle East. Buprenorphine, a partial agonist has also become more prevalent as an alternative to methadone. Both compounds will be discussed in detail:

KW - Opioid agonist pharmacotherapy

KW - Opioid agonist treatment

KW - METHADONE

M3 - Chapter

SN - 978-1-1-4462-9867-1

SP - 345

EP - 355

BT - The SAGE Handbook of Drug and Alcohol Studies: Biological Approaches

A2 - Wolff, Kim

A2 - White, Jason

A2 - Karch, Steven

PB - Sage Publications

CY - London, UK

ER -