Sim S K
Can Med Assoc J. 1973 Oct 6;109(7):615-9.
Methadone and acetylmethadol, although possessing almost all of morphine's pharmacological properties, differ from other morphine-like drugs in their longer action, more gradual and less intense withdrawal syndrome, and blockade of euphoric effect of other opiates in addicts. A high percentage of patients maintained on methadone are better able to hold employment or to be otherwise socially productive than when dependent on heroin or morphine.A review of published results and procedures used in methadone maintenance treatment programs for heroin dependence is presented. Former heroin addicts are usually maintained on 80 to 120 mg. (high dose) or 20 to 60 mg. (low dose) oral methadone daily. Some programs are reported to have produced 80% success (patients employed or otherwise socially productive). Selection of patients, availability of allied therapeutic and rehabilitative facilities, strict control of supply, record keeping and periodic evaluation are considered essential.Different criteria ("drug-free" vs. "socially productive") for judging "success" of treatment of heroin-dependent persons by methadone maintenance and administrative problems in large-scale treatment programs constitute the principal aspects of controversy.
美沙酮和乙酰美沙酮虽然几乎具备吗啡的所有药理特性,但与其他类吗啡药物不同,它们作用时间更长,戒断综合征更缓慢且不那么强烈,还能阻断成瘾者对其他阿片类药物的欣快感。与依赖海洛因或吗啡时相比,接受美沙酮维持治疗的患者中有很大比例能更好地保住工作或在其他方面对社会有所贡献。本文综述了用于海洛因依赖美沙酮维持治疗项目的已发表结果及程序。从前的海洛因成瘾者通常每日口服80至120毫克(高剂量)或20至60毫克(低剂量)美沙酮。据报道,有些项目成功率达80%(患者有工作或在其他方面对社会有所贡献)。患者的选择、相关治疗和康复设施的可及性、严格的供应管控、记录保存及定期评估被认为至关重要。通过美沙酮维持治疗海洛因依赖者“成功”的不同评判标准(“无药物”与“对社会有贡献”)以及大规模治疗项目中的管理问题构成了争议的主要方面。