Opioids medical applications

Ultimately, the cultivation, sale, and possession of cannabis is illegal at present in most places. Individuals who use it for whatever purpose in most areas carry the risk of arrest and prosecution. From the perspective of addictiveness, it seems inconsistent that cannabis use is prohibited, while the use of alcohol and nicotine are permitted. Apart from arguments about the recreational use of cannabis, resistance to its medical application is even more inconsistent. For example, the opioids carry some risk for dependence, but with medical supervision they are useful medications and their abuse is minimal (Joranson et al. 2000). Whether use of cannabis is to be permitted and for which purposes (medical or recreational) remains to be collectively decided by society and the legislators it appoints. 

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. 

Many studies have examined the efficacy of a variety of psychosocial treatments for alcohol, cocaine, and opioid use disorders, alone and in conjunction with pharmacotherapy. However, only a handful of studies have explored how these two treatment approaches may interact. More research is needed to further explore the ways in which psychosocial interventions may be used in conjunction with pharmacotherapy to optimize outcomes for both treatments. Providing encouragement for abstinence, greater treatment retention, medication adherence, and coping with medication side effects are some potential applications of psychosocial therapies. 

Belknap SM, Moore H, Lanzotti SA, Yarnold PR, Getz M, Deitrick DL, Peterson A, Akeson J, Maurer T, Soltysik RC, Storm GA, Brooks I. Application of software design principles and debugging methods to an analgesia prescription reduces risk of severe injury from medical use of opioids. Clin Pharmacol Ther 2008 84(3) 385-92. 

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