Synopses & Reviews
Review
"Although a multi-authored text, the various chapters manage a similarity of style and organization that suggest good overall editing. All in all this is a very useful book for clinicians charged with the responsibility of treating opioid addicts and for those wanting to learn the basics of the field." --Charles P. O'Brien, MD, PhD, Treatment Research Center, University of Pennsylvania
"Cocaine, the drug of the 80s, is being increasingly supplanted by heroin, the chic drug of the 90s. Fortunately, good treatments for heroin addiction already exist, and better ones are on the horizon. Unfortunately, clinicians, policy makers, and the lay public are often unaware of the options and which approach is best for which patient. Drs. Stine and Kosten have put together an excellent guide to what exists for the treatment of opiate addiction. Standard approaches such as methadone and naltrexone are described as well as the newer ones of acupuncture, LAAM, and buprenorphine. Since medications by themselves are usually insufficient, the psychosocial concomitants are also described, as well as how to match patients to the most appropriate approach. The book is scholarly and well written, and will be an important guide for treating both the 'new' middle-class addict and the existing diversity of patients." --Herbert D. Kleber, MD, Professor of Psychiatry and Director of the Division on Substance Abuse, Columbia University College of Physicians and Surgeons
Synopsis
This state-of-the-art volume integrates chapters on the scientific basis of opiate addiction with a comprehensive survey of the latest treatment methods, including traditional and new pharmacotherapies, adjunct therapies, and management of comorbid substance abuse and medical conditions. An opening section reviews the fundamental neurobiological principles guiding clinical intervention. Chapters then describe the impact of recent scientific breakthroughs on the success of traditional pharmacotherapy, focusing on the evolution of methadone maintenance programs the primary treatment for opiate dependence for over 30 years. The book also describes and evaluates ancillary services such as psychosocial interventions, day programs, and acupuncture; considers the specific treatment needs of diverse populations; and explores cutting-edge developments in the field.
About the Author
Susan M. Stine, MD, PhD, is Assistant Clinical Professor of Psychiatry at Yale University School of Medicine and Director of the Opiate Treatment Program at the VA Connecticut Healthcare System in West Haven. She is author of a variety of scientific publications in pre-clinical neuroscience and clinical pharmacotherapy, and serves on the editorial board of several professional journals.
Thomas R. Kosten, MD, is Professor of Psychiatry at Yale University School of Medicine, where he is also Director of the Division of Substance Abuse, and Chief of Psychiatry at the VA Connecticut Healthcare System in West Haven. Coeditor of the Guilford Substance Abuse Series, he serves as editorial consultant or board member for a number of professional journals and has published over 250 papers, books, and reviews
Table of Contents
1 Introduction and Overview, T. R. Kosten and Stine
I. Foundations for the New Interventions
2. Behavioral Models of Opiate Abuse in Animals, T. A. Kosten
3. Basic Neurobiology of Opiate Addiction, Nestler
II. Optimizing Traditional Treatments
A. Refining the Use of Pharmacotherapy
4. New Developments in Methadone Treatment and Matching Treatments to Patients, Stine
5. Use of Pharmacological Agents in OpiateDetoxification, Rosen
6. Naltrexone and Opiate Abuse: Who Benefits from It and How to Increase Its
Effectiveness, Farren, O'Malley, and Rounsaville
7. Comorbid Substance Abuse in Opiate Dependent Patients, Burns
B. Ancillary Services and Special Populations
8. Matching Methadone-Maintained Patients to Psychosocial Treatments, Avants, Ohlin, and Margolin
9. Acupuncture for Cocaine Abuse: Research Findings, Methodological Issues, and Patient Treatment Matching, Margolin and Avants
10. Women and Opiate Dependence, Chang
11. Medical Issues in the Care of Opioid-Dependent Patients, O'Connor and Selwyn
III. The New Pharmacotherapies
12. Opiate Maintenance Therapy with LAAM, Ling and Compton
13. Buprenorphine, Oliveto and T. R. Kosten
14. Conclusions and Future Directions in Treatment Matching, T. R. Kosten