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Oct 28 12 7:10 AM

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Chapter 5. Clinical Pharmacotherapy



In This Chapter …



Contraindications to Opioid Pharmacotherapy



Stages of Pharmacotherapy



Medically Supervised Withdrawal



Take-Home Medications



Office-Based Opioid Therapy



This chapter describes pharmacotherapy in opioid treatment programs (OTPs), in particular the clinical use of methadone, with limited discussion of levo-alpha acetyl methadol (LAAM) and buprenorphine. More limited coverage is provided on the opioid antagonist naltrexone, which is not used widely for opioid addiction treatment in the United States. As explained in chapter 3, at this writing most OTPs have discontinued the use of LAAM for new patients, and its continued availability is uncertain. TIP 40, Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction (CSAT 2004a ), provides more detailed information about buprenorphine.



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