Federal regulation of methadone treatment / / Richard A. Rettig and Adam Yarmolinsky, editors ; Committee on Federal Regulation of Methadone Treatment, Division of Biobehavioral Sciences and Mental Disorders, Institute of Medicine

• Pubblicazione: Washington, D.C., : National Academy Press, 1995
• Edizione: 1st ed.
• Descrizione fisica: 1 online resource (250 p.)
• Disciplina: 353.0084/29
• Soggetto topico: Methadone maintenance - Government policy - United States; Drug monitoring - Government policy - United States; Methadone hydrochloride
• Altri autori: RettigRichard A YarmolinskyAdam
• Note generali: Bibliographic Level Mode of Issuance: Monograph
• Nota di bibliografia: Includes bibliographical references.
• Nota di contenuto: 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.
• Titolo autorizzato: Federal regulation of methadone treatment
• ISBN: 0-309-17658-1; 1-280-19303-4; 9786610193035; 0-309-59862-1; 0-585-15457-0
• Formato: Materiale a stampa
• Livello bibliografico: Monografia
• Lingua di pubblicazione: Inglese
• Record Nr.: 9910817702903321
• Lo trovi qui: Univ. Federico II