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Medically Supervised Withdrawal for Opioid Dependence

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Abstract

Medically supervised withdrawal from opioids can be accomplished with a variety of pharmacologic techniques. The use of agonists, antagonists, and partial agonists are widely utilized in practice today. Clonidine has been used historically to manage the adrenergic (autonomic) symptoms of opioid withdrawal. Methadone has been the gold standard for opioid agonist therapy (OAT) and is rapidly being replaced by sublingual buprenorphine. This treatment is available for the primary care physician upon fulfilling certain requirements to utilize sublingual buprenorphine. As the prescription drug epidemic continues, it is important for the practitioner to recognize the overlap between chronic pain and opioid dependence, as well as the treatment of both.

Keywords

  • Sublingual buprenorphine
  • Opioid dependence
  • Medically supervised withdrawal
  • Drug Addiction Treatment Act
  • Clonidine
  • Methadone
  • Prescription drug abuse
  • Office-based opioid detoxification

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Fig. 40.1

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Correspondence to Sanford M. Silverman M.D. .

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Silverman, S.M. (2015). Medically Supervised Withdrawal for Opioid Dependence. In: Kaye, A., Vadivelu, N., Urman, R. (eds) Substance Abuse. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1951-2_40

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  • DOI: https://doi.org/10.1007/978-1-4939-1951-2_40

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1950-5

  • Online ISBN: 978-1-4939-1951-2

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