Opioids alcohol dependence

Opioidergic agents. Naltrexone and nalmefene, opioid antagonists with no intrinsic agonist properties, have been studied for the treatment of alcohol dependence. Naltrexone has been studied much more extensively than nalmefene for this indication. In 1984 naltrexone was approved by the FDA for the treatment of opioid dependence, and in 1994 it was approved for the treatment of alcohol dependence. Nalmefene is approved in the United States as a parenteral formulation for the acute reversal of opioid effects (e.g., after opioid overdose or analgesia). 

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Studies have shown that CM can be used to directly reinforce adherence to medication treatments as well (Petty 2000). Liebson et al (1978) found that methadone-maintained alcohol-dependent patients reduced alcohol use when methadone treatment was contingent on disulfiram consumption. To date, one of the most common applications of CM techniques to pharmacotherapy has been the provision of vouchers or cash contingent upon naltrexone consumption in recently detoxified opioid-dependent patients (Carroll et al. 2001, 2002 Preston et al. 1999). These studies have generally reported significant increases in retention and reductions in opioid use among patients receiving the CM treatment, relative to other therapies. 

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Itzhak Y. Differential regulation of brain opioid receptors following repeated cocaine administration to guinea pigs. Drug Alcohol Depend. 3 53, 1993. 

Herz A. Implications of the multiplicity of opioid receptors for the problem of addiction. Drug Alcohol Depend. 25 125, 1990. 

Esteban J, Gimeno C, Barril J, Aragones A, Climent JM and de la Cruz-Pellin M (2003). Survival study of opioid addicts in relation to its adherence to methadone maintenance treatment. Drug and Alcohol Dependence, 70, 193-200. 

The use of structurally rigid DKPs as bioactive models for opioid receptor antagonists has been proposed. These compounds are used in the elucidation of the binding requirements and will lead to the design of highly selective molecules with potential clinical application for diseases of the opioid system. These include the treatment of autism, alcohol dependency, and modulation of immunity Further studies by Baures has... 

Narcotic addiction Blockade of the effects of exogenously administered opioids. A/co/ o//s/t . Treatment of alcohol dependence. 

Use opioids with caution in patients with alcoholism or other drug dependencies because of the increased frequency of opioid tolerance, dependence, and the risk of addiction observed in these patient populations. Abuse of opioids in combination with other CNS depressants can result in serious risk to the patient. 

CS285 HemandeZ Avila, C. A., B. J. Rounsa-ville, and H. R. Kranzler. Opioid-, cannabis- and alcohol-dependent women show more rapid progression to sub-... 

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Farre M, Mas A, Torrens M, Moreno V Cami J (2002). Retention rate and illicit opioid use during methadone maintenance interventions a meta-analysis. Drug Alcohol Dependence, 65, 283-90... 

Miotto K, McCann M, Basch J, Rawson R ling W (2002). Naltrexone and dysphoria fact or myth American Journal of Addictions, 11, 151-60 Mitchell TB, White JM, Somogyi AA Bodmer F (2003). Comparative pharmacodynamics and pharmacokinetics of methadone and slow-release oral morphine for maintenance treatment of opioid dependence. Drug and Alcohol Dependence, 11, 85-94 Mitchell TB, White JM, Somogyi AA Bochner F (2004). Slow-release oral morphine versus methadone a crossover comparison of patient outcomes and acceptability as maintenance pharmacotherapies for opioid dependence. Addiction, 99, 940-5 Mitka M (2003). Office-based primary care physicians called on to treat the new addict. Journal of the American Medical Association, 290, 735-6... 

In summary, naltrexone and perhaps other opioid antagonists such as nalmefene are promising agents in the pharmacotherapy of alcohol dependence with or without coexisting psychiatric and addictive disorders (418). 

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Greenwald, M.K., Johanson, C.E., and Schuster, C.R., Opioid reinforcement in heroin-dependent volunteers during outpatient buprenorphine maintenance, Drug Alcohol Depend., 56, 191, 1999. 

Zacny, J. et al., College on Problems of Drug Dependence taskforce on prescription opioid nonmedical use and abuse position statement, Drug Alcohol Depend., 69, 215, 2003. 

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