Treating XXXX . Growing implications for primary care.

@entity1 @entity34318 @entity4784 @entity102 @entity4783 @entity284 @entity70991 @entity943
Almost 3 million Americans have abused heroin. The most effective treatment for this concerning epidemic is opioid replacement therapy. Although, from a historical perspective, acceptance of this therapy has been slow, growing evidence supports its efficacy. There are 3 approved medications for opioid maintenance therapy: @entity284 , @entity34318 , and @entity4783 . Each has unique characteristics that determine its suitability for an individual @entity1 . @entity943 have been reported with @entity284 and @entity70991 , but not with @entity4783 . Due to concerns about cardiac risk, @entity70991 use has declined and the product may ultimately be discontinued. These recent safety concerns, specifics about opioid detoxification and maintenance, and new federal initiatives were studied. @entity4784 has a role in both preventing acute withdrawal and maintaining long-term abstinence. Although only a minority of eligible @entity1 are engaged in treatment, opioid maintenance therapy appears to offer the greatest public health benefits. There is growing interest in expanding treatment into primary care, allowing opioid addiction to be managed like other @entity102 . This model has gained wide acceptance in Europe and is now being implemented in the United States. The recent Drug Addiction Treatment Act enables qualified physicians to treat opioid-dependent @entity1 with @entity4783 in an office-based setting. Mainstreaming opioid addiction treatment has many advantages; its success will depend on resolution of ethical and delivery system issues as well as improved and expanded training of physicians in addiction medicine.
