Consideration of a North American heroin-assisted clinical trial for the treatment of opiate-dependent individuals
Bibliographic Data
| ID | 14908393 |
|---|---|
| Authors | Irene Kuo (0000-0002-3437-0216), Irene C Kuo (0000-0001-9350-5478, Johns Hopkins University, corresponding author), Benedikt Fischer (0000-0002-2186-4030, Centre for Addiction and Mental Health), David Vlahov (0000-0003-4007-4445, New York Academy of Medicine) |
| Year | 2000 |
| Volume | 11 |
| Issue | 5 |
| Pages | 357-370 |
| Publication date | 2000-09-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | International Journal of Drug Policy (JOURNAL) |
| Journal identifiers | ISSN: 0955-3959 • E-ISSN: 1873-4758 |
| Publisher | Elsevier BV (PUBLISHER) |
| DOI | 10.1016/s0955-3959(00)00057-8 |
| PMID | 10967518 |
| OpenAlex | W2115681179 |
| Language | EN |
| Citations received | 2 |
| References cited | 57 |
Untreated opiate addiction remains a major public health problem in North America (US and Canada). Increased morbidity and mortality as well as criminal behavior related to untreated opiate dependence constitute significant social and economic burdens. While the principal treatment modality to opiate addiction in North America has been methadone treatment since the 1960s, its reach and effectiveness has been limited; at any given time, only about 25% (US) and 15-20% (Canada) of all opiate addicts are in methadone treatment. Reasons for low levels of treatment participation among this subset of users include perceptions among users that treatment programs are punitive and that the medication is fraught with side effects. In the meantime, alternatives to methadone have been recently approved or are in development, including levo-alpha acetylmethadol and buprenorphine. However, the extent to which they will solve the current problem is still unknown, and therefore development of additional treatment strategies needs to continue. Recent studies of heroin-assisted treatment in Europe (Switzerland, the Netherlands and Great Britain) produced preliminary yet encouraging results in attracting and retaining long-term, treatment-resistant addicts in treatment, as well as improving treatment outcomes. However encouraging, the North American context differs from Europe. A study performed in North America would provide critical information on whether utilizing injectable opiates enhances the overall therapeutic attractiveness and effectiveness of substance abuse treatment to a subset of recalcitrant users. Implications of positive results would expand the continuum of effective interventions in the US and Canada, and increase the number of long-term, treatment-resistant opiate addicts in treatment
Addiction · Buprenorphine · Context (archaeology · Drug · Geography · Heroin · Methadone · Opiate · Opioid · Psychiatry · Psychological intervention · Public health · Substance abuse · HIV, Drug Use, Sexual Risk · Medicine · Opioid Use Disorder Treatment · Psychology · Substance Abuse Treatment and Outcomes · Internal Medicine
Taking Care of Business
Needle exchange is not enough
Attitudes Toward Methadone Maintenance
Social costs of untreated opioid dependence
Drugs and Crime
The estimated prevalence and incidence of HIV in 96 large US metropolitan areas
Viral infections in short-term injection drug users
Utilization of health services in a cohort of intravenous drug users with known HIV-1 serostatus
Heroin addiction, crime and economic cost
Heroin Substitution in Canada
The Case for a Heroin Substitution Treatment Trial in Canada
| Unique citing works | 2 |
|---|---|
| Citations per year | 0.14 |
| Citation span | 2012 - 2025 (14) |
| Citation velocity | recent |
| Highly cited | No |
| Citation types | Neutral: 2 |