Evidence-Based Treatment of Opioid-Dependent Patients!

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Description:
Objective: To provide an overview of treatment options for opioid-dependent patients.
Method: We screened all published studies on the treatment of opioid dependence, with a
special focus on systematic literature reviews, formal metaanalyses, and recent trials.
Results: Both clinical experience and neurobiological evidence indicate that opioid
dependence is a chronic relapsing disorder. Treatment objectives depend on the pursued
goals: crisis intervention, abstinence-oriented treatment (detoxification and relapse
prevention), or agonist maintenance treatment. The high quality of solid evidence in the
literature demonstrates that there are numerous effective interventions available for the
treatment of opioid dependence. Crisis intervention, frequently necessary owing to the high
overdose rate, can be effectively handled with naloxone. Abstinence-oriented interventions
are effective for only a few motivated patients with stable living conditions and adequate
social support. Agonist maintenance treatment is considered the first line of treatment for
opioid dependence. Numerous studies have shown efficacy for methadone and
buprenorphine treatment, while maintenance with other agonists is also becoming available
to a greater extent. Maintenance treatment with diamorphine should be made available for
the small group of treatment-resistant, severely dependent addicts. Other harm-reduction
measures can serve to engage individuals with opioid addiction who are not in treatment.
Conclusion: Opioid dependence is a chronic relapsing disease that is difficult to cure, but
effective treatments are available to stabilize patients and reduce harm, thereby increasing
life expectancy and quality of life

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