Drugs used in the treatment of the addictions

Fergus D. Law and David J. Nutt

Medications jnpers.pe.ct]ye Specific drugs. used., in addiction, treatment Methadone

L-a-Acetylmethadol, hydrochJoii.de

Buprenorphine

Dihydrocodeinetart.ra.te

Naltrexone

Naloxone

Cloni.dinellhyd,IOchlloIide Lofexidine

Ac.ampros.ate (calcium, l,a,c,ety,l,,h,om,ot,a,u,ri.n,at,e) Disulfiram

Chapter, References

The role of medical treatments in the addictions has been and remains controversial. Indeed they have been associated with a bewildering range of individual and social perspectives, with addiction itself viewed as a lifestyle problem, a resetting of normal brain systems highjacked by drugs, or as a medical illness. However, many of these controversies may be avoided by taking a goal-oriented approach to treatment, which is consistent with all of these possible views. In this approach clinical objectives are defined, and both medications and psychological interventions are used to facilitate progress towards these objectives. Thus effectiveness is optimized when medications are used as one component of a comprehensive treatment plan.

There are no 'magic bullets' in addiction treatment—the same pharmacological principles apply to these drug treatments as to any other. Drugs need to be given in effective doses, at appropriate intervals, allowed time to reach steady state, and also to dissipate when terminated on the basis of their half-life. Some drugs also have an abuse potential of their own (e.g. opiates, sedative-hypnotics) especially those with a rapid onset of action, and thus such drugs need to be particularly closely monitored and controlled, in order to minimize their diversion and misuse.

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