Improved HIV and Substance Abuse Treatment Outcomes for Released HIV-Infected Prisoners: The Impact of Buprenorphine Treatment

Abstract  HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to
improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized
controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these,
30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX.
Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline,
the proportion with a non-detectab…

Improved HIV and Substance Abuse Treatment Outcomes for Released HIV-Infected Prisoners: The Impact of Buprenorphine Treatment

Abstract  HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to
improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized
controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these,
30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX.
Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline,
the proportion with a non-detectab…

Improved HIV and Substance Abuse Treatment Outcomes for Released HIV-Infected Prisoners: The Impact of Buprenorphine Treatment

Abstract  HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to
improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized
controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these,
30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX.
Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline,
the proportion with a non-detectab…

The pharmacological treatment of opioid addiction—a clinical perspective

This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include
detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of
rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone
combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of
intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered.
Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment
of addictive disorders, a m…

The pharmacological treatment of opioid addiction—a clinical perspective

This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include
detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of
rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone
combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of
intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered.
Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment
of addictive disorders, a m…

The pharmacological treatment of opioid addiction—a clinical perspective

This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include
detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of
rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone
combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of
intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered.
Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment
of addictive disorders, a m…

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A multi-site, two-phase, Prescription Opioid Addiction Treatment Study (POATS): Rationale, design, and methodology

Abstract: The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (b…

A multi-site, two-phase, Prescription Opioid Addiction Treatment Study (POATS): Rationale, design, and methodology

Abstract: The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (b…

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A multi-site, two-phase, Prescription Opioid Addiction Treatment Study (POATS): Rationale, design, and methodology

Abstract: The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (b…