Catalogo Articoli (Spogli Riviste)


Effective medical treatment of opiate addiction
Judd, LL; Attkisson, C; Berrettini, W; Buc, NL; Bunney, BS; Dominguez, RA; Friedel, RO; Gustafson, JS; Hedeker, D; Hiatt, HH; Mostaghim, R; Petersdorf, RG;
Univ Calif San Diego, Sch Med, Dept Psychiat, La Jolla, CA 92093 USA Univ Calif San Diego La Jolla CA USA 92093 ychiat, La Jolla, CA 92093 USA Univ Calif San Francisco, San Francisco, CA 94143 USA Univ Calif San Francisco San Francisco CA USA 94143 ancisco, CA 94143 USA Univ Penn, Sch Med, Dept Psychiat, Philadelphia, PA 19104 USA Univ Penn Philadelphia PA USA 19104 Psychiat, Philadelphia, PA 19104 USA Yale Univ, Sch Med, Dept Psychiat, New Haven, CT USA Yale Univ New Haven CT USA iv, Sch Med, Dept Psychiat, New Haven, CT USA Univ Miami, Sch Med, Dept Psychiat, Miami, FL 33152 USA Univ Miami Miami FL USA 33152 Sch Med, Dept Psychiat, Miami, FL 33152 USA Univ Alabama, Dept Psychiat & Behav Neurobiol, Birmingham, AL 35294 USA Univ Alabama Birmingham AL USA 35294 Neurobiol, Birmingham, AL 35294 USA Natl Assoc State Alcohol & Drug Abuse Directors I, Washington, DC USA NatlAssoc State Alcohol & Drug Abuse Directors I Washington DC USA USA Univ Illinois, Sch Publ Hlth, Div Epidemiol & Biostat, Chicago, IL USA Univ Illinois Chicago IL USA h, Div Epidemiol & Biostat, Chicago, IL USA Harvard Univ, Sch Med, Cambridge, MA 02138 USA Harvard Univ Cambridge MA USA 02138 niv, Sch Med, Cambridge, MA 02138 USA Brigham & Womens Hosp, Dept Med, Div Gen Med, Boston, MA 02115 USA Brigham& Womens Hosp Boston MA USA 02115 v Gen Med, Boston, MA 02115 USA Univ Washington, Seattle, WA 98195 USA Univ Washington Seattle WA USA 98195 iv Washington, Seattle, WA 98195 USA
Titolo Testata:
fascicolo: 22, volume: 280, anno: 1998,
pagine: 1936 - 1943
Tipo documento:
Settore Disciplinare:
Clinical Medicine
Life Sciences
Indirizzi per estratti:
Indirizzo: Judd, LL Univa,alif San Diego, Sch Med, Dept Psychiat, 0667,9500 Gillman Dr, La Joll Univ Calif San Diego 0667,9500 Gillman Dr La Jolla CA USA 92093 l
L.L. Judd et al., "Effective medical treatment of opiate addiction", J AM MED A, 280(22), 1998, pp. 1936-1943


Objective.-To provide clinicians, patients, and the general public with a responsible assessment of the effective approaches to treat opiate dependence. Participants.-A nonfederal, nonadvocate, 12-member panel representing the fields of psychology, psychiatry, behavioral medicine, family medicine, drug abuse, epidemiology, and the public. In addition, 25 experts from these same fields presented data to the panel and a conference audience of 600, Presentations and discussions were divided into 3 phases over 2 1/2 days: (1)presentations by investigators working in the areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of a third day. The conference was organized and supported by the Office of Medical Applications of Research, National Institutes of Health. Evidence.-The literature was searched through MEDLINE and other National Library of Medicine and online databases from January 1994 through September1997 and an extensive bibliography of 941 references was provided to the panel and the conference audience. Experts prepared abstracts for their presentations as speakers at the conference with relevant citations from the literature. Scientific evidence was given precedence over clinical anecdotal experience. Consensus Process.-The panel, answering predefined questions, developed its conclusions based on the scientific evidence presented in open forum and the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and releaseda revised statement at the end of the conference. The panel finalized the revisions within a few weeks af; ter the conference. The draft statement was made available on the World Wide Web immediately following its release atthe conference and was updated with the panel's final revisions. Conclusions-Opiate dependence is a brain-related medical disorder that canbe effectively treated with significant benefits for the patient and society, and so ciety must make a commitment to offer effective treatment for opiate dependence to all who need it. All persons dependent on opiates shouldhave access to methadone hydrochloride maintenance therapy under legal supervision, and the US Office of National Drug Control Policy and the US Department of Justice should take the necessary steps to implement this recommendation. There is a need for improved training for physicians and other health care professionals. Training to determine diagnosis and treatment of opiate dependence should also be improved in medical schools. The unnecessaryregulations of methadone maintenance therapy and other long-acting opiate agonist treatment programs should be reduced, and coverage for these programs should be a required benefit in public and private insurance programs.

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Documento generato il 03/04/20 alle ore 20:40:00