Although the ultimate goal of treatment programs is to achieve drug-free status as quickly as possible, it is rarely achieved without pharmacotherapy. The most commonly used strategy is to switch the patient from a short-acting opioid, such as heroin, to a long-acting ag onist, such as methadone. It is easier to withdraw patients from methadone because it produces a protracted withdrawal syndrome that is less intense than that produced by heroin.
Opioid antagonists, such as naltrexone, provide another treatment option in that addicts who are completely withdrawn from an opioid can be maintained on antagonists that will block the pleasurable effects of subsequent injections of heroin. Mixed opioid agonist-antagonists show promise in that they have sufficient agonist effects to reduce craving while at the same time exhibiting antagonist properties.
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