Federal regulation of methadone treatment
| Autor Corporativo: | |
|---|---|
| Otros Autores: | , |
| Formato: | Libro electrónico |
| Idioma: | Inglés |
| Publicado: |
Washington, D.C. :
National Academy Press
1995.
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| Edición: | 1st ed |
| Materias: | |
| Ver en Biblioteca Universitat Ramon Llull: | https://discovery.url.edu/permalink/34CSUC_URL/1im36ta/alma991009820334006719 |
Tabla de Contenidos:
- Federal Regulation of Methadone Treatment
- Copyright
- Acknowledgments
- Contents
- Federal Regulation of Methadone Treatment
- Executive Summary
- HOW METHADONE IS REGULATED
- SCOPE OF THE REPORT
- BALANCING THE BENEFITS AND RISKS OF METHADONE
- RECOMMENDATIONS TO MODIFY AND SUPPLEMENT THE REGULATIONS
- Diagnosing Addiction and Determining Dose Levels
- Habilitative and Rehabilitative Services
- Treating Pregnant Opiate Addicts
- Replacing "Detoxification" with "Medically Supervised Withdrawal
- Inpatient Hospital Admissions
- Treating Opiate Addiction and Treating Pain
- ENFORCEMENT OF THE REGULATIONS
- GUIDELINES AND QUALITY ASSURANCE
- PROCESS EVALUATION AND OUTCOME EVALUATION
- FEDERAL GOVERNMENT LEADERSHIP
- REFERENCE
- 1 Introduction
- THE CHARGE TO THE COMMITTEE
- OBJECTIVES OF OPIATE ADDICTION TREATMENT
- EFFECTIVENESS OF METHADONE MAINTENANCE TREATMENT
- Beneficial Outcomes
- Factors Limiting Effectiveness
- Multiple Problems of Methadone Maintenance Patients
- Variability among Methadone Maintenance Programs
- WHY METHADONE IS REGULATED DIFFERENTLY FROM OTHER DRUGS
- THE COMMITTEE'S VIEW
- REPORT ORGANIZATION
- STUDY METHODS
- A NOTE ON TERMINOLOGY
- REFERENCES
- 2 Pharmacology and Medical Aspects of Methadone Treatment
- THE RATIONALE FOR PHARMACOTHERAPY
- History and Practice
- Basic Science
- PHARMACOKINETICS OF METHADONE
- METHADONE MAINTENANCE
- Treatment Regimen
- Effects, Side Effects, and Special Pharmacological Issues
- Physiological Functions Disrupted During Heroin Addiction
- INTERACTIONS OF METHADONE WITH OTHER DRUGS
- IMPACT OF METHADONE MAINTENANCE ON INFECTIOUS DISEASES
- REFERENCES
- 3 Who are the Recipients of Treatment?
- HEROIN USE AND DEPENDENCE
- Prevalence of Heroin Use
- From Use to Dependence
- How Persistent is Heroin Dependence?.
- Age, Gender, and Ethnicity
- Age
- Gender
- Ethnicity
- What Other Substances Do Heroin Users Consume?
- Other Medical and Social Problems of Heroin-Dependent Persons
- How Likely Are Heroin Addicts to Use Treatment?
- CHARACTERISTICS OF UNTREATED AND TREATED HEROIN ADDICTS
- METHADONE PATIENT CHARACTERISTICS
- Historical Trends
- Current Patient Characteristics
- Methadone in Drug Treatment: General
- Use of Methadone in Detoxification
- Use of Methadone in Maintenance Treatment
- Contrast between Detoxification and Maintenance Patient Admissions
- Maintenance Patients in New York State
- 1992
- Maintenance Patients in California, 1992
- Differences Between New York and California
- SUMMARY
- REFERENCES
- 4 Methadone Diversion Control
- EARLY CONCERN OVER DIVERSION
- THE NARCOTIC ADDICT TREATMENT ACT OF 1974
- MORE RECENT OFFICIAL VIEWS ON DIVERSION
- House Select Committee Hearings
- Perspective of the Drug Enforcement Administration
- THE DATA ON DIVERSION
- Drug Abuse Warning Network Data
- Harris County, Texas
- Harris County Medical Examiner Data
- Methadone Maintenance Treatment Data
- Independent Pathologists' Review
- Drug Abuse Warning Network (DAWN) Medical Examiner Data
- Other Data on Diversion
- Drug Use Forecasting Data
- National AIDS Demonstration Research (NADR) Data
- HOW IS METHADONE DIVERTED?
- Production and Distribution System
- Sale by Patients: Who Sells and Why?
- WHO USES DIVERTED METHADONE AND WHY?
- CONSEQUENCES OF METHADONE DIVERSION
- Public Safety Issues
- Public Health Issues
- Is Diverted Methadone Dangerous?
- Is Diverted Methadone a Major Drug of Abuse?
- SUMMARY
- APPENDIX
- REFERENCES
- 5 Federal Regulation of Methadone Treatment
- THE 1960S
- THE NIXON ADMINISTRATION
- 1970 Legislation
- Special Action Office for Drug Abuse Presentation.
- DEFINING THE REGULATORY REGIME: 1970-1974
- Research, Treatment, and Regulation
- Methadone IND Regulations
- 1972 Regulations
- Legal Challenge to the FDA
- Narcotic Addict Treatment Act of 1974
- Summary: 1970-1974
- THE CURRENT REGULATORY REGIME
- 1980 Revision of the Regulations
- 1989 Revision of the Regulations
- 1983 Regulatory Reform Initiative
- 1987 Notice of Proposed Rule-Making
- 1989 Final Rule
- 1989 Guidance Document
- 1989 Interim Methadone Maintenance Proposal
- Assessment of Program Performance
- LEVO-ALPHA-ACETYL-METHADOL
- SUMMARY
- REFERENCES
- 6 Methadone Treatment
- THE PROVIDER COMMUNITY
- Number of Treatment Facilities
- Regional Variation
- Number of Patients
- Capacity and Utilization Rate
- Waiting Lists
- Facility Ownership
- FINANCING OF METHADONE TREATMENT
- Department of Veterans Affairs
- Out-of-Pocket and Private Insurance
- STATE SUBSTANCE ABUSE AGENCIES
- New York
- Financing
- Regulations
- California
- Financing
- Regulations
- Florida
- Financing
- Regulations
- Illinois
- Financing
- Regulations
- Massachusetts
- Financing
- Regulations
- SUMMARY
- REFERENCES
- 7 Treatment Standards and Optimal Treatment
- DEFINITION OF TERMS
- PATIENT EVALUATION AND ADMISSION CRITERIA
- Admission to Medically Supervised Withdrawal
- Admission to Maintenance Pharmacotherapy
- Proper Patient Placement
- Two Conclusions
- MAINTENANCE PHARMACOTHERAPY
- Dosing
- Comprehensive Treatment Services
- Take-Home Medication
- Urine Testing
- Implications for Regulations
- Opiate Addiction in Pregnant Women
- MEDICALLY SUPERVISED WITHDRAWAL
- INPATIENT TREATMENT
- Maintenance Pharmacotherapy in Hospital Inpatient Settings
- Inpatients with Untreated Opiate Addiction
- PAIN MANAGEMENT
- Non-Opiate-Addicted Pain Patients
- Methadone Patients.
- ''Recovering" Opiate and Other Substance Dependent Patients
- CONCLUDING COMMENTS
- REFERENCES
- 8 Implementing Standards-and Beyond
- REGULATIONS AND THEIR ENFORCEMENT
- CLINICAL PRACTICE GUIDELINES
- FORMAL QUALITY ASSURANCE SYSTEMS
- WHAT CAN BE DONE NOW?
- Process Evaluation
- Outcome Evaluation
- FEDERAL GOVERNMENT LEADERSHIP
- Research Issues
- Clinical Research
- Health Services Research
- Federal-State Relations
- Financing of Treatment
- Policy Guidance
- SUMMARY
- REFERENCES.
