Criminal Justice; "Healing..."

Buprenorphine Post
Posts: 24

Postby drdavemcdowell » Tue May 18, 2004 8:10 am

How did it go?

Dave McDowell
Director, Columbia Buprenorphine Program
212 342 1496

Posts: 22

Postby judymartin » Tue May 18, 2004 8:10 am

We do have some evidence of normalization of brain function with methadone maintenance. For example, Guralnyk et al, and Stimmel and Kreek, both in the Mount Sinai Journal of Medicine, see refs below. We expect similar good results with buprenorphine maintenance treatment.
Galynker, I. I., S. Watras-Ganz, et al. (2000). "Cerebral metabolism in opiate-dependent subjects: effects of methadone maintenance." The Mount Sinai Journal of Medicine 67(Nos. 5 & 6): 381-387
Stimmel, B. and M. J. Kreek (2000). "Neurobiology of Addictive Behaviors and Its Relationship to Methadone Maintenance." the Mount Sinai journal of medicine 67(Nos. 5&6): 375-380.
Also, there is a good review of literature on attempts to taper, and the high relapse rates:
Magura, S. and A. Rosenblum (2001). "Leaving methadone treatment: lessons learned, lessons forgotten, lessons ignored." The Mount Sinai Journal of Medicine 68(No. 1): 62-74.
The reason I chose these particular articles is that you can download them by going to the Mount Sinai School of Medicine website, then choose the journal link and back issues. There are two very comprehensive issues that cover every aspect of maintenance treatment with methadone.
In terms of educating lay folks, I like the McLellan article that compares addiction to chronic illness:
McLellan, A. T., D. C. Lewis, et al. (2000). "Drug Dependence, a Chronic Medical Illness." JAMA 284(October 4): 1689-1695.
I am not familiar with any judicial literature, but Judge Peggy Hora, who is a drug court judge in California, has given lectures about proper treatment for opiate addiction. Perhaps she has published?
Our state chapter of ASAM has written to judges about proper treatment for opioid dependence, perhaps your professional organization could help? If you would like copies of letters to judges, I believe you can get them, try the website
Good luck to your patient, and to you.

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