Whelan Paul J, Remski Kimberly
Department of Psychiatry, Central and North West London NHS Foundation Trust, North Westminster Community Mental Health Team for Older Adults, Latimer House, London, UK .
J Neurosci Rural Pract. 2012 Jan;3(1):45-50. doi: 10.4103/0976-3147.91934.
Heroin dependence is a major health and social problem associated with increased morbidity and mortality that adversely affects social circumstances, productivity, and healthcare and law enforcement costs. In the UK and many other Western countries, both methadone and buprenorphine are recommended by the relevant agencies for detoxification from heroin and for opioid maintenance therapy. However, despite obvious benefits due to its unique pharmacotherapy (eg, greatly reduced risk of overdose), buprenorphine has largely failed to overtake methadone in managing opioid addiction. The experience from the developing world (based on data from India) is similar. In this article we compare the advantages and disadvantages of the use methadone and buprenorphine for the treatment of opioid addiction from both a developed and developing world perspective; and explore some of the reasons why buprenorphine has not fulfilled the expectations predicted by many in the addictions field.
海洛因依赖是一个重大的健康和社会问题，与发病率和死亡率的增加相关，对社会环境、生产力、医疗保健及执法成本产生不利影响。在英国和许多其他西方国家，相关机构推荐美沙酮和丁丙诺啡用于海洛因脱毒及阿片类药物维持治疗。然而，尽管丁丙诺啡因其独特的药物疗法具有明显益处（如，大大降低过量用药风险），但在治疗阿片类药物成瘾方面，丁丙诺啡在很大程度上未能超越美沙酮。发展中国家（基于印度的数据）的情况类似。在本文中，我们从发达国家和发展中国家的角度比较使用美沙酮和丁丙诺啡治疗阿片类药物成瘾的优缺点；并探讨丁丙诺啡未能达到成瘾领域许多人预期的一些原因。
