Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.
Evidence that drug (including alcohol) dependence is a chronic medical illness is examined and results suggest that long-term care strategies of medication management and continued monitoring produce lasting benefits.
Abstinence symptomatology and psychiatric diagnosis in cocaine abusers. Clinical observations.
Longitudinal evaluations showed a three-phase sequence of post-cocaine abuse abstinence symptoms, and over half the sample also met criteria for ed 3 DSM-III, axis I psychiatric disorders.
The economic costs of heroin addiction in the United States.
Can the national addiction treatment infrastructure support the public's demand for quality care?
Heterogeneity of psychiatric diagnosis in treated opiate addicts.
- B. Rounsaville, M. Weissman, H. Kleber, C. Wilber
- Psychology, MedicineArchives of General Psychiatry
- 1 February 1982
A survey evaluated current and lifetime rates of psychiatric disorders in 533 opiate addicts in treatment at a multimodality program, suggesting the importance of detecting and attending to psychopathology associated with opiate addiction.
Amphetamine-induced dopamine release: markedly blunted in cocaine dependence and predictive of the choice to self-administer cocaine.
Blunted dopamine transmission in the ventral striatum and anterior caudate was predictive of the choice for cocaine over money, and this impairment appears to play a critical role in relapse.
Methadone maintenance 4 decades later: thousands of lives saved but still controversial.
- H. Kleber
- 19 November 2008
A combination of the methadone treatment and a comprehensive program of rehabilitation was associated with marked improvement in patient problems such as jobs, returning to school, and family reconciliation.
Cocaine Dependence and D2 Receptor Availability in the Functional Subdivisions of the Striatum: Relationship with Cocaine-Seeking Behavior
This study confirms previous reports of a modest decrease in D2 receptors availability in CCD subjects, and establishes that this decrease is generalized throughout the striatum, but fails to demonstrate a relationship between D2 receptor availability and cocaine-induced cocaine-taking behavior.
Desipramine facilitation of initial cocaine abstinence.
It is indicated that desipramine is an effective general treatment, for this first treatment stage, in actively cocaine-dependent outpatients.
Pharmacologic treatments for opioid dependence: detoxification and maintenance options
- H. Kleber
- Medicine, PsychologyDialogues in Clinical Neuroscience
- 1 December 2007
Excluding those with short-term habits, the best outcome occurs with long-term maintenance on methadone or buprenorphine accompanied by appropriate psychosocial interventions, and those with strong external motivation may do well on the antagonist naltrexone.