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Kosten, T. R., & George, T., P. (2002,
July). The neurobiology of opioid dependence:
Implications for treatment. NIDA Science &
Practice Perspectives, 1, 1.
Opioid tolerance, dependence, and addiction are
all manifestations of brain changes resulting
from chronic opioid abuse. The opioid abuser's
struggle for recovery is in great part a struggle
to overcome the effects of these changes. Medications
such as methadone, LAAM, buprenorphine, and naltrexone
act on the same brain structures and processes
as addictive opioids, but with protective or normalizing
effects. Despite the effectiveness of medications,
they must be used in conjunction with appropriate
psychosocial treatment.
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Jackson, T. R. (2002, July). Treatment practice
and research issues in improving opioid treatment
outcomes. NIDA Science & Practice Perspectives,
1, 1.
Providers of
treatment for opioid addiction have entered a
new era of accountability, as Federal and State
regulators increasingly demand objective evidence
of treatment effectiveness. Since the length of
treatment is associated with the success of treatment,
opioid treatment programs that demonstrate an
ability to retain patients can make a strong case
for their effectiveness. The challenge to opioid
treatment providers is to examine their practices
and begin organizational change to incorporate
scientifically proven practices to improve patient
retention. The challenge to the research community
is to partner more effectively with community-based
providers to help them through the transition.
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Brooner, R. K., & Kidorf, M. (2002, July).
Using behavioral reinforcement to improve methadone
treatment participation. NIDA Science &
Practice Perspectives, 1, 1.
A new service delivery system for the treatment
of opioid dependence, called "motivational
stepped care," matches the intensity of counseling
services to each patient's clinical progress.
Adherence to a counseling schedule is reinforced
through the linking of counseling attendance with
the patient's methadone dosage schedule and, ultimately,
his or her ability to continue receiving treatment
services. This article describes the scientific
evidence that supports the major elements of the
model, the model in action, and evaluations that
have been conducted to date.
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