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Human Experimental Therapeutic Models in Opioid Dependence (Paperback, New)
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Human Experimental Therapeutic Models in Opioid Dependence (Paperback, New)
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This book selectively discusses recent advances in human
experimental models relating to the treatment of opioid dependence.
The author critically reviewed three independent lines of research
conducted during the past decade with heroin-dependent volunteers.
One research strategy involves studying the -opioid receptor ( OR),
which is the molecular target for the reinforcing and physical
dependence producing effects of heroin-like drugs. This has been
accomplished by varying medication dose conditions, measuring the
availability of brain -receptors in vivo and plasma
pharmacokinetics, then correlating these biological concentration
measures with clinically relevant endpoints including opioid
withdrawal symptoms, heroin craving, and blockade of the euphoric
and respiratory depressant effects of -agonist challenges. These
studies provide an initial benchmark for estimating OR occupancy or
plasma concentration requirements for effective pharmacotherapy. A
second research strategy determines the conditions under which
-agonist medications function as reinforcers, and the ability of
medication dose and the availability of non-drug alternative
reinforcement to attenuate opioid choice. Taken together, these
studies provide information relevant to the ability of the
medication to stimulate adherence and reduce drug demand. A third
research strategy seeks to determine whether non-opioid medications
can attenuate the naloxone-precipitated (i.e. withdrawal related)
discriminative stimulus, subjective and/or physiological effects in
opioid-maintained individuals. These studies aim to identify
compounds that may be safe and effective adjuncts during opioid
detoxification and, potentially, anti-relapse agents. Evidence is
also reviewed concerning individual differences identified in these
models. Implications of these findings for clinical treatment are
also discussed.
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