TREATMENT OF OPIATE ADDICTION
Buprenorphine Therapy of Opiate Addiction, 1stEdition, Edited by Pascal Kintz and Pierre Marquet. Hard Bound, 6" x 9".
(A Book from Forensic Science and Medicine Series by Humana Press)
Humana Press Inc., 999 Riverview Drive, Suite 208, Totowa, New Jersey 07512; xvi + 148 pages: ISBN 1 - 58829 - 031 - X (alk. Paper). Publication Date 01/29/2002: Price, $89.50
This is a further volume in the growing Forensic Medicine and Science Series edited by Steve Karch. This impressive series embraces a range of forensic topics. The style is now familiar, good topic editors with a broad spectrum of specialist authors contributing within their own area of expertise. Opiate addiction is - in my view - one of the scourges of modern society - in my country directly related to the ever-expanding crime rate. Any therapy that may improve on the high relapse and failure rates of current treatments must be welcomed. The use of buprenorphine - a semi-synthetic opioid derivative as an alternative to methadone substitution has been pioneered and developed in France, from where the vast majority of contributors originate.
Approximately 70,000 addicts in France have been treated using high dosage formulations. The book is comprehensive in its coverage addressing pharmacological, physiological and clinical issues.
|..the lists of references make it worthwhile reading for anyone in contact with patients who are opiate addicted...|
There is substantial coverage of the role of buprenorphine in pregnancy and for neonates. One Chapter is entitled 'Case Study of Neonates Born to Mothers Undergoing Buprenorphine Maintenance Treatment'. This appears to be a report of a case control series of 23 neonates born to mothers undergoing buprenorphine maintenance. I am not sure that a book is the place to publish what appears to be a full study which has not (unless I am mistaken) been through a clear peer-review process (if it has then I offer my apologies). There is no doubt that buprenorphine has a potentially significant role to play in the treatment of those with heroin addiction. However the benefits do come at a price. The chapter on buprenorphine related deaths is salutary - 137 deaths since its introduction in a high dosage form for substitution therapy for heroin misusers. The authors themselves admit that this incidence may be a large underestimate.
The book does not convince me that buprenorphine is the treatment for heroin addiction for which we are looking. However the detail, and the lists of references make it worthwhile reading for anyone in contact with patients who are opiate addicted.
-Jason Payne James
Dr. Jason Payne James is on the editorial board of Anil Aggrawal's Internet Journal of Forensic Medicine and Toxicology. Click image to have more information about him.
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