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REVIEW

Pharmacologic Treatment of Heroin-Dependent Patients

Patrick G. O'Connor, MD, MPH, and David A. Fiellin, MD

4 July 2000 | Volume 133 Issue 1 | Pages 40-54

Patients with heroin dependence frequently present to internists and other physicians for heroin-related medical, psychiatric, and behavioral health problems and often seek help with reducing their heroin use. Thus, physicians should be familiar with the identification and diagnosis of heroin dependence in their patients and be able to initiate treatment of heroin dependence both directly and by referral. Recent research has provided much information concerning effective pharmacologically based treatment approaches for managing opioid withdrawal and helping patients to remain abstinent. Methadone maintenance and newer approaches using L- acetylmethadol and buprenorphine seem to be particularly effective in promoting relapse prevention. Although these treatments are currently provided in special drug treatment settings, recent and ongoing research indicates that the physician's office may be an effective alternative site for these treatments.

Author and Article Information

From Yale University School of Medicine and Yale–New Haven Hospital Primary Care Center, New Haven, Connecticut.

Grant Support: Dr. Fiellin is supported by the National Institute on Drug Abuse Physician Scientist Award (K12 DA00167).

Requests for Single Reprints: Patrick O'Connor, MD, MPH, Yale University School of Medicine, 333 Cedar Street, Box 208025, New Haven, CT 06520.

Requests To Purchase Bulk Reprints (minimum, 100 copies): the Reprints Coordinator; phone, 215-351-2657; e-mail, reprints{at}mail.acponline.org.

Current Author Addresses: Drs. O'Connor and Fiellin: Yale University School of Medicine, 333 Cedar Street, Box 208025, New Haven, CT 06520.

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