Opioid dependence and its associated morbidity, mortality, and social
costs continue to plague societies around the world. Opioid dependence is
characterized by physical dependence as evidenced by tolerance and withdrawal
and by behavioral problems, including the inability to control opioid use,
opioid use despite adverse consequences, and social dysfunction. The 2003
National Survey on Drug Use and Health reported that 3.7 million Americans
had used heroin at some time in their lives.1 The
Monitoring the Future Survey noted that approximately 1.2% of 10th- and 12th-graders
reported ever using heroin in 2004.2 In addition,
the recent trend of increasing abuse of prescription opioids including oxycodone,
propoxyphene, hydrocodone, hydromorphone, and meperidine has been a major
concern since the late 1990s. The National Survey on Drug Use and Health1 estimated that as of 2003, more than 31.2 million
Americans had used narcotic pain relievers in a “nonmedicinal”
manner sometime in their lives and 11.7 million were “past year”
nonmedicinal users in 2003.1 The Monitoring
the Future Survey indicated that 6.2% of 10th-graders and 9.3% of 12th-graders
used hydrocodone and 3.5% of 10th-graders and 5.0% of 12th-graders used oxycodone
in 2004.2 These statistics and the overall
lack of access to high-quality treatment resources for opioid-dependent individuals3 point directly to the urgent need to develop new treatment
strategies for opioid dependence while expanding access to established treatment
approaches known to be effective.
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