A Medical Treatment for Diacetylmorphine (Heroin) Addiction

Dole, Vincent P.; Nyswander, Marie

doi:10.1097/00043764-196604000-00028

Cited by 280 publications

(220 citation statements)

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“…It is, therefore, possible that, in addition to reducing the physical symptoms of narcotic withdrawal, levamisole might also attenuate the effects of the narcotic-induced withdrawal on the reward system and/or alter the reward properties of narcotic agonists. Methadone is widely used in the treatment of narcotic addiction, but its efficacy derives from its cross tolerance with heroin and morphine (Dole and Nyswander 1965). Thus, although methadone administration does prevent withdrawal effects and reduces drugseeking behavior, it does not alleviate the neurobiological basis of the addiction.…”

Section: Discussionmentioning

confidence: 99%

Effects of the Immunostimulant, Levamisole, on Opiate Withdrawal and Levels of Endogenous Opiate Alkaloids and Monoamine Neurotransmitters in Rat Brain

Spector

Munjal

Schmidt

1998

Neuropsychopharmacology

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Section: Discussionmentioning

confidence: 99%

Effects of the Immunostimulant, Levamisole, on Opiate Withdrawal and Levels of Endogenous Opiate Alkaloids and Monoamine Neurotransmitters in Rat Brain

Spector

Munjal

Schmidt

1998

Neuropsychopharmacology

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“…The Rockefeller team began using methadone as a replacement for heroin in their research on feasibility of opioid maintenance therapy, under the hypothesis that methadone occupied a receptor and satisfied the craving in heroin addiction. The first 22 patients had excellent results [6]. They stopped having what he called Bnarcotic hunger^; their craving was satisfied with methadone.…”

Section: Methadone History and The Early Pioneersmentioning

confidence: 99%

“…They stopped having what he called Bnarcotic hunger^; their craving was satisfied with methadone. In 1965, Dole and Nyswander published their first paper, BA Medical Treatment for Diacetylmorphine (Heroin) Addiction-A Clinical Trial with Methadone Hydrochloride.^This work demonstrated that methadone, accompanied by a comprehensive program of rehabilitation, was an effective treatment for heroin addiction [6]. The Dole/Nyswander treatment paradigm involved comprehensive treatment techniques, with the goal of reintegration into society.…”

Section: Methadone History and The Early Pioneersmentioning

confidence: 99%

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Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”

Salsitz

Wiegand

2015

J. Med. Toxicol.

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Methadone maintenance therapy (MMT), a pharmacological treatment for opioid use disorder for the past 50 years, continues to remain controversial. Despite consistent and overwhelming evidence confirming the effectiveness and safety of MMT, misconceptions and myths persist regarding its legitimacy as a treatment for opioid addiction. This often results in the underutilization and limited availability of this treatment modality. Despite successful outcomes, the controversial nature of MMT, and the stigma experienced by the patients on methadone, has been a particularly difficult obstacle to overcome. We present the history of MMT, review the evidence for its efficacy in the treatment of opioid dependence, and explore the origins of the stigma and misconceptions related to MMT.

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“…In 2014, the prevalence of opioid dependence was estimated at 0.4% for the European Union (European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), 2014). Medication-assisted treatment (MAT) with methadone, lpolamidone, buprenorphine or slow-release oral morphine sulphate is considered to be the treatment of first choice (Dole and Nyswander, 1965;Mattick et al, 2014Mattick et al, , 2009Ward et al, 1999;WHO, 2009). Due to the chronicity of opioid dependence, current treatment guidelines favor the open-end nature of MAT, sometimes required to continue lifelong (APA, 2006; Swiss Society of Addiction Medicine (SSAM), 2013).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of medication-assisted treatment of opioid dependence—The physicians’ perspective

Vogel

Nordt

Dürsteler

et al. 2016

Drug and Alcohol Dependence

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BACKGROUND: There is controversy about which outcome parameters should be employed to assess substance use treatment. Subjective measures of medication-assisted treatment (MAT) of opioid dependence are increasingly important. However, while patients' perspectives have been examined, the caregivers' views remain largely unknown. Here, we explore how physicians evaluate MAT, and which predictors are most relevant. METHODS: We conducted a retrospective cohort study of all MAT episodes with oral opioid agonists in the canton of Zurich between 1998 and 2013 using a case register. Termination forms of the register include a physician-completed assessment on the course of the treatment episode. Mixed model analysis was applied to determine relevant predictors. RESULTS: The analysis was based on 17,234 episodes from 7432 patients. Mean global assessment of the course of MAT was 'moderate'. The most important predictors for treatment evaluation by physicians were treatment break off as reason for termination (p<0.0001), psychological improvement throughout treatment (p<0.0001), wish for abstinence from the substitute (p<0.0001), social integration index at termination (p<0.0001), and social (p<0.0001) as well as medical (p<0.0001) improvement. The negative association of treatment break off with MAT assessment was more pronounced in semi-rural than urban areas (p<0.0001). CONCLUSION: Predictors relating to the well-being and functioning of the patient as well as the reasons underlying treatment termination appear to be more important for the treating physician's evaluation of medication-assisted treatment episodes than on-going substance use. Coming off the opioid medication plays a central role, independent of ongoing illicit substance use. Predictors relating to the well-being and functioning of the patient as well as the reasons underlying treatment termination appear to be more important for the treating physician's evaluation of medication-assisted treatment episodes than on-going substance use. Coming off the opioid medication plays a central role, independent of ongoing illicit substance use.

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A Medical Treatment for Diacetylmorphine (Heroin) Addiction

Cited by 280 publications

References 0 publications

Effects of the Immunostimulant, Levamisole, on Opiate Withdrawal and Levels of Endogenous Opiate Alkaloids and Monoamine Neurotransmitters in Rat Brain

Effects of the Immunostimulant, Levamisole, on Opiate Withdrawal and Levels of Endogenous Opiate Alkaloids and Monoamine Neurotransmitters in Rat Brain

Pharmacotherapy of Opioid Addiction: “Putting a Real Face on a False Demon”

Evaluation of medication-assisted treatment of opioid dependence—The physicians’ perspective

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