• Publications
  • Influence
Drug dependence, a chronic medical illness: implications for treatment, insurance, and outcomes evaluation.
TLDR
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.
  • F. Gawin, H. Kleber
  • Psychology, Medicine
    Archives of general psychiatry
  • 1 February 1986
TLDR
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.
TLDR
The large economic burden resulting from heroin addiction highlights the importance of investment in prevention and treatment, both to the addict and society at large.
Can the national addiction treatment infrastructure support the public's demand for quality care?
TLDR
Findings are disturbing and call into question the ability of the national treatment system to meet the complex demands of both the patients that enter this system and the agencies that refer to it.
Heterogeneity of psychiatric diagnosis in treated opiate addicts.
TLDR
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.
TLDR
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.
TLDR
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
TLDR
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.
Pharmacologic treatments for opioid dependence: detoxification and maintenance options
  • H. Kleber
  • Medicine
    Dialogues in clinical neuroscience
  • 1 December 2007
TLDR
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.
Lower level of endogenous dopamine in patients with cocaine dependence: findings from PET imaging of D(2)/D(3) receptors following acute dopamine depletion.
TLDR
The decrease in striatal D(2)/D(3 )receptors associated with cocaine dependence cannot be attributed to higher levels of endogenous dopamine.
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