Principles of medical interventions in addiction?
Replacement prescribing
Detox and relapse prevention
BZDs
Criteria for opiate detox?
Shorter history
Uncomplicated
Relatively stable socially
Criteria for opiate blockade?
Impulsive relapsers and ? liver disease
Options for detox?
Self detox w/ support
Reducing prescribed opioids
Alpha 2 adrenergic agonists (Lofexidine)
Adjunctive treatment eg NSAID, loperamide, hypnotic
Options for opioid substitution therapy?
Methadone or bruprenorphine