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Review of Pharmacotherapies for Substance Abuse

NCJ Number
166663
Journal
American Journal on Addictions Volume: 5 Issue: 4, Supplement 1 Dated: (Fall 1996) Pages: 530-537
Author(s)
T R Kosten; E McCance
Date Published
1996
Length
8 pages
Annotation
New pharmacotherapies have been developed for acute withdrawal and maintenance treatment of alcohol and opioid dependence but not for cocaine dependence.
Abstract
Several new pharmacotherapies have been developed to treat abusers of alcohol, opioids, and stimulants. These agents provide either relief of acute withdrawal or prevention of relapse. The major goal of acute withdrawal agents is to reduce the duration and severity of withdrawal symptoms. Maintenance treatments can be either blocking or substitution agents. Blocking agents facilitate drug abstinence by preventing the abused drug from producing behavioral and physiological effects. Substitution agents such as methadone prevent illicit drug use by reducing drug hunger and withdrawal and by producing cross-tolerance. Specifically, high-dose, long-acting benzodiazepines, beta blockers, and two antiseizure agents--carbamazepine and valproate--are being used for alcohol withdrawal. For maintenance treatment, opioid antagonists and various serotonergic agents such as fluoxetine and ondansetron show promise. For opioid dependence, clonidine-naltrexone detoxification appears to be cost-effective, and buprenorphine and LAAM (levo-alpha- acetylmethadol) show promise for both detoxification and maintenance. More work is needed, however, to discover an effective agent for treating cocaine abusers. 70 references

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