Substance abuse treatment modalities in the age of HIV spectrum disease

AMSAODD's Third National Forum on AIDS and Chemical Dependency presented a session about the theory and practicality of combining pharmacologic and nonpharmacologic treatment modalities to maximize the social, psychological, and physical health of patients. Synthesizing methadone maintenance for opioid dependence with abstinence modalities for cocaine dependence and alcoholism was discussed. Chronic adequate methadone treatment allows normalization of neuroendocrine function, is associated with normal natural killer-cell activity, and has proven efficacious in retaining patients in chemical dependence treatment, and thus decreasing the risk for transmission of HIV infection. Individualization of treatment is then exemplified by four clinical vignettes that were discussed by a panel of experts.