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Managing illicit drug use. A practical guide

A Wodak1

  • 1Alcohol and Drug Service, St Vincent's Hospital, Darlinghurst, New South Wales, Australia.

Drugs
|March 1, 1994
PubMed
Summary
This summary is machine-generated.

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Methadone maintenance treatment effectively reduces heroin use, mortality, and HIV risk. Optimal outcomes require higher doses, longer treatment durations, and realistic goals for illicit drug users.

Area of Science:

  • Addiction Medicine
  • Pharmacology
  • Public Health

Background:

  • Illicit drug use is a growing global concern, particularly in developing nations, with treatment responses often culturally influenced.
  • Methadone maintenance treatment (MMT) is a key pharmacotherapeutic intervention for heroin dependence, supported by substantial research.
  • HIV infection is a critical public health issue linked to illicit drug use, especially among injection drug users.

Purpose of the Study:

  • To review the evidence for pharmacotherapeutic treatments for illicit drug use.
  • To highlight the effectiveness of methadone maintenance treatment for heroin dependence.
  • To discuss the status and potential of other pharmacotherapies like LAAM, buprenorphine, and naltrexone.

Main Methods:

  • Literature review of studies on psychosocial and pharmacotherapeutic treatments for illicit drug use.

Related Experiment Videos

  • Analysis of evidence supporting methadone maintenance treatment, including its impact on heroin use, mortality, criminal activity, and HIV infection.
  • Examination of findings for alternative treatments such as LAAM, buprenorphine, and naltrexone.

    • Main Results:

    • Methadone maintenance treatment demonstrates significant benefits, including reduced heroin use, mortality rates, and HIV transmission.
    • Higher methadone doses, longer treatment durations, and realistic treatment goals are associated with improved outcomes.
    • Methadone maintenance programmes are effective in retaining individuals in treatment and reducing HIV spread among heroin injectors.
    • Levo-alpha-acetylmethadol (LAAM) shows promise but lacks regulatory approval; buprenorphine is under evaluation; naltrexone may suit specific populations; cocaine/amphetamine treatments are developmental.

    Conclusions:

    • Methadone maintenance treatment is a highly effective intervention for heroin dependence, offering substantial public health benefits.
    • Implementation of evidence-based practices in methadone treatment, such as optimal dosing and duration, is crucial for maximizing effectiveness.
    • Further research and regulatory approval are needed for alternative pharmacotherapies, while treatments for stimulant use remain in early development.