Abstract
Most, if not all, primary care physicians will be faced with the question of how to manage the addicted/alcoholic patient. In this chapter, we discuss how to (1) determine when you should utilize inpatient versus outpatient detoxification; (2) become knowledgeable regarding various methods of outpatient detoxification for each of the specific drugs of abuse; (3) manage patients pharmacologically after discharge from an inpatient detoxification setting; and (4) use the various medications available for your patients to assist in minimizing their relapse potential.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Dupont RL, Gold MS. Withdrawal and reward: implications for detoxification and relapse prevention. Psychiatr Ann 1995;25(11): 663–668.
Adinoff B, O’Neill HK, Ballenger JC. Alcohol withdrawal and limbic kindling: a hypothesis of relapse. Am J Addict 1995;4: 5–17.
Saitz R. Unhealthy alcohol use. N Engl J Med 2005;352: 596–607.
Heilig M, Egli M. Pharmacological treatment of alcohol dependence: target symptoms and target mechanisms. Pharmacol Ther 2006;111: 855–876.
Miller L, Greenblatt DJ, et al. Chronic benzodiazepine administration I: tolerance is associated with benzodiazepine receptor down regulation and decreased GABA receptor function. J Pharmacol Exp Ther 1988;246(1): 170–176.
Miller L, Greenblatt DJ, et al. Chronic benzodiazepine administration II: discontinuation syndrome is associated with up regulation of GABA receptor complex binding and function. J Pharmacol Exp Ther 1988;246(1): 177–181.
Miller L. Chronic benzodiazepine administration: from patient to gene. J Clin Pharmacol 1991;31: 492–495.
Graham AW, Schultz TK, eds. Principles of Addiction Medicine, 2nd ed. Chevy Chase, MD: American Society of Addiction Medicine; 1998.
Gold M, Redmond DE, Kleber HD. Clonidine blocks acute opiate withdrawal symptoms. Lancet 1978;2: 599–600.
Gold MS, Pottash AC, Sweeney DR, Kleber HD. Opiate withdrawal using clonidine. JAMA 1980;243: 343–346.
Ahmadi-Abhari SA, Akhondzadeh S, Assadi SM, Shabestari OL, Farzanehgan ZM, Kamlipour A. Baclofen versus clonidine in the treatment of opiates withdrawal, sideeffects aspect: a double-blind randomized controlled trial. J Clin Pharm Ther 2001;26: 67–71.
Drug Addiction Treatment Act of 2000 (DATA 2000). Title XXXV, Section 3502 of the Children’s Health Act of 2000. Waiver Authority for Physicians Who Dispense or Prescribe Certain Narcotic Drugs for Maintenance Treatment or Detoxification Treatment. Public Law 106–310 106th Congress, An Act. Available at: http:// buprenorphine.samhsa.gov/fulllaw.html.
Johnson RE, Jones HE, Fischer G. Use of buprenorphine in pregnancy: patient management and effects on the neonate. Drug Alcohol Depend 2003;70: S87–S101.
Johnson RE, Strain EC, Amas L. Buprenorphine: how to use it right. Drug Alcohol Depend 2003;70: 559–577.
InfoFacts: Cigarettes and Other Tobacco Products. Bethesda, MD: National Institute on Drug Abuse. Revised July 11, 2006. Available at: http://www.drugabuse.gov/infofacts/tobacco.html.
The Office on Smoking and Health. Tobacco Information and Prevention Source. National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention. 2006. Available at: http://www.cdc.gov/tobacco/issue.htm.
Schroeder SA. What to do with a patient who smokes. JAMA 2005;294(4): 482–487.
Gold MS, Edwards DW. Treating cigarette smokers in 2000. Your Patient Fitness 2000;14(4);6–11.
Leshner AI. Drug abuse and mental disorders: co-morbidity is reality [director’s column]. NIDANotes 1999;14(4).Availableat: http://www.nida.nih.gov/NIDA_Notes/ NNVol14N4/DirRepVol14N4.html.
Krestan J-A. Bridges to Recovery: Addiction, Family Therapy and Multicultural Treatment. New York: The Free Press; 2000.
Straussner SLA, ed. Ethnocultural Factors in Substance Abuse Treatment. New York: The Guilford Press; 2002.
Primm B, Brown L Jr, Primm A, Friedman J. Tobacco, alcohol and drugs. In Satcher D, Pamies R, eds. Multicultural Medicine and Health Disparities. New York: McGraw-Hill; 2006.
Cooper L. Drug Use Among Racial/Ethnic Minorities. Bethesda, MD: National Institute on Drug Abuse, provided scientific oversight, critical review, and substantive comments for this publication, revised 2003. For questions or comments on this documents, please send an e-mail to De. Leslie Cooper at: lc58q@nih.gov. Available at: www.drugabuse.gov.
Rights and permissions
Copyright information
© 2007 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
(2007). Pharmacologic Office-Based Interventions. In: Management of the Addicted Patient in Primary Care. Springer, New York, NY. https://doi.org/10.1007/978-0-387-71885-9_4
Download citation
DOI: https://doi.org/10.1007/978-0-387-71885-9_4
Publisher Name: Springer, New York, NY
Print ISBN: 978-0-387-35961-8
Online ISBN: 978-0-387-71885-9
eBook Packages: MedicineMedicine (R0)