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Interview: Medications in the Treatment of Opioid Dependence

After his presentation at the Nevada Psychopharmacology Course, Dr. Earley was interviewed by Clinical Psychiatry News. Medications are taking a more central role in the treatment of all types of addictive diseases, but especially in the treatment of Opioid Dependence. "What is important here is that there is no 'One size fits All' in medications for opioid dependence," Dr. Earley asserts. Take a moment and read the nice synopsis of the issues in medication management of Opioid Dependence by clicking here.

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New Interviews with Dr. Earley

HookedHollywoodMainStreet OpeningImageWhile combing through our archives, we came across two important interviews with Dr. Paul Earley. These interviews are extracted from hour-long specials produced by ABC news in the 1990s. Despite the fact that these interviews are about 15 years old, they provide important insights about heroin addiction. We hope you find them helpful. The first interview is from Hooked: from Hollywood to Main Street. Click here for Dr. Earley’s interview from Hooked: from Hollywood to Main Street

The second interview is from Heroin: The New High School High. Click here for Dr. Earley’s interview from Heroin: The New High School High.

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Our experience with MDPV or "Bath Salts"

The latest designer drug to hit the United States is the compound Methylenedioxypyrovalerone (MDPV) marketed in the United States commonly as "bath salts." It is sold under many names in the southern part of the US (where we are), including "Ivory Wave" or "Purple Wave." It is sold in drug paraphernalia stores (head shops) but is commonly available in gas station markets and adult novelty stores. It is easily obtained and extremely dangerous.

What is MDPV? MDPV belongs to a category of drugs called cathinones. One natural souce of cathinones is from the drug khat, a dried plant derivative native to tropical East Africa and the Arabian Peninsula. Although related to more benign drugs, MDPV has several alarming properties.

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FDA Approves Injectable Naltrexone for Opioid Addiction

Today we have another tool in the treatment of narcotic dependence. Vivitrol (the brand name) for injectable naltrexone has been approved for the treatment of opioid dependence. We have been using this medication for over two years in the treatment of opioid (narcotic) dependence and feel like it is an excellent medication in the right person. Like all medications, injectable naltrexone is not for everyone. We have extensive experience in using this medication in two groups of patients:
1) Individuals that have been using potent opioids (such as heroin, oxycodone and hydrocodone for a brief to moderate period of time (usually less than 3 to 5 years) who are motivated for abstinence and have some type of support (families who can set loving limits, a work setting or other social controls). Our greatest experience has been with young adults, ages 18 to 30 who become opioid dependent.  In this group, injectable naltrexone provides a safety net after detoxification that prevents relapse while behavioral therapies (psychotherapy and 12 step support groups) take hold.
2) The other group are individuals in safety sensitive jobs, such as health care workers. We have had over 25 years of experience in treating this population, and I can say that in this group, injectable naltrexone is the single most important new development in our treatment. We are having excellent outcomes in returning opioid dependent health care practitioners to work when they have considerable access to the very drugs that have been their downfall. At the same time, public safety is ensured.
I will be posting more about this important medication over the next few weeks. In the meantime here are several links:

On the 12th of October 2010, the FDA has approved another tool for the treatment of opioid dependence: injectable naltrexone. Here are several links about this important development: FDA Press Release,  CNN First Story.Vivitrol is the brand name for the injectable naltrexone approved by the FDA for the treatment of opioid dependence.

We have been using this medication for over two years in the treatment of opioid (narcotic) dependence and feel like it is an excellent medication for the right person. Up until today, this use has been "off label" meaning that the FDA did not directly endorse its efficacy in opioid dependence (it was previously FDA approved only for alcohol dependence).

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