Methadone Maintenance Treatment and Other Opioid Replacement Therapies

Edited by Jeff Ward, Richard P. Mattick and Wayne Hall

The 1980's and 1990's have witnessed a world-wide epidemic of heroin addiction, and countries around the world have moved to put in place opiate replacement therapy programs in order to deal with this problem. Whilst most of these programs use methadone as the substitute drug of choice, most recently Buprenorphine, LAAM (levo acetyl methadol) and naltrexone have been employed for this purpose.

Methadone Maintenance Treatment and Other Opioid Replacement Therapies is a comprehensive guide to the use of drug substitution in the treatment of opiate dependence. This handbook provides an up-to-date account of treatment research and practice in this growing area. As well as answering questions about the status of this class of interventions in terms of their demonstrated effectiveness, it also includes detailed discussions of assessment issues, appropriate dosage regimens, the role of ancillary social and psychological service s, the use of opiate replacement therapy in prisons, optimal treatment during pregnancy and the cost-effectiveness of this form of treatment.

This book will be of interest to medical practitioners, drug and alcohol treatment personnel, policy makers and anyone with an interest in the management of opiate dependence.

About the Editors

Jeff Ward is a Lecturer in Health Psychology in the Division of Psychology at Australian National University. Richard P. Mattick is the Director of Research and Wayne Hall is Executive Director at the National Drug and Alcohol Research Centre, University of New South Wales, Australia.

Contents

The effectiveness of methadone maintenance treatment 1:Heroin use and crime 2:HIV and infectious hepatitis 3:Moderators of treatment outcome 4:Cost-effectiveness - The effectiveness of other opioid replacement therapies:LAAM, heroin, buprenorphine, naltrexone and injectable maintenance - Delivering effective methadone treatment - Assessment for opioid replacement therapy -The use of methadone during maintenance treatment:Pharmacology, dosage and treatment outcome - The use of urinalysis during opioid replacement therapy - The role of counselling and psychological therapy - How long is enough? Answers to questions about the duration of methadone maintenance treatment - Making the transition from maintenance to abstinence - Detoxification from methadone maintenance treatment - Staff training in methadone clinics - The provision of methadone within prison settings - Methadone maintenance during pregnancy - Psychiatric cormorbidity among the opioid dependent -the future of opioid replacement therapy.

ISBN No. 90-5702-239-7: 480 pages 1998

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