Management of Opioid Abuse and Dependence: A Review of the Current and Novel Approaches

In this review the reader will be updated about the most recent guidelines for treatment of opioid abuse and dependence. The first phase of treatment which is managing the opioid withdrawal syndrome and detoxification will be described in details. The opioid agonist maintenance treatment with either methadone or buprenorphine for patients who fail abstinent based models will be elaborated. Opioid antagonists like naltrexone maintenance which are another form of treatment for patients who do not qualify for or desire opioid agonist maintenance treatment will also be elaborated. Treatment of special populations such as adolescents and opioid dependent pregnant women is included in this review. Psychotherapeutic interventions will be discussed with emphasis on contingency management (CM) since it is the most studied intervention in this population. Finally new approaches for treatment will be mentioned briefly.