Advocacy for methadone treatment

Article Abstract:

Methadone treatment programs for heroin addicts have been impressively successful, keeping three quarters of the enrollees involved for a year or more and claiming elimination of heroin use in more than 90 percent of treated patients. Human immunodeficiency virus (the agent associated with AIDS) is transmitted at a much lower rate among participants in these programs (10 percent of those in a methadone program versus 10 percent of heroin addicts since 1987). In spite of this promising record, methadone programs have not expanded since the mid-1970s in New York. They are currently running at 100 percent of their funded capacity, while new applicants wait weeks or months for a space. As these programs find similar success worldwide, so, too, do they similarly struggle for political survival in many other countries. Although addiction is a treatable disease that can affect anyone, internal medicine physicians have been remarkably uninvolved in treating it. Assumptions that may cause them to hold back include beliefs like: the disease is complex and self-imposed; the addict is uncooperative; and addiction is ultimately incurable. But cannot the same be said for many diseases? Physicians cannot be forced to treat specific patients or specific diseases, but all patients must be able to obtain help in managing their potentially fatal disease. Internists should take some decision-making power in this arena from nonmedical people, and demand the institution of sufficient methadone treatment programs. The political and social spheres of influence are highly appropriate places for physicians to exercise influence. Treatment must be given to those who need it. (Consumer Summary produced by Reliance Medical Information, Inc.)

Social aspects, Evaluation, Political activity, Political aspects, Heroin habit, editorial, Internists

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Dose-response effects of methadone in the treatment of opioid dependence

Article Abstract:

Opioid addicts treated with a higher dosage of methadone may be more likely to stop using illicit drugs than those treated with a lower dosage. Methadone is a synthetic opioid used to treat individuals who are dependent on opioid drugs. Among 247 opioid-dependent patients with a high incidence of cocaine use, 81 were treated with zero milligrams (mg), 82 with 20 mg and 84 with 50 mg of methadone per day over a 15-week period. All of the patients were initially treated for five weeks with methadone. Patients in the 50 mg group remained in the treatment program longer than those in the 20 mg or zero mg group. Individuals treated with 50 mg were less likely to use opioid drugs or cocaine than those treated with 20 mg or zero mg. The use of intravenous cocaine has increased among drug addicts who are in methadone maintenance programs.

Physiological aspects, Opioids, Drug addicts, Drug abusers

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Biological basis for cancer treatment

Article Abstract:

Advances in cancer biology will be useful not only in biotherapy but also in enhancing conventional chemotherapy. Biotherapy advocates who point to the limited effectiveness of cancer chemotherapy and call for dramatic cutbacks in anticancer drug research fail to acknowledge the importance of cancer biology in current drug discovery efforts. Cancer drugs now target specific cancer types and growth regulators. Applications of cancer biology which improve drug specificity will increase drug effectiveness and reduce toxic side effects. Biological therapies are promising but also have limitations, and their implementation is not yet feasible. In the future, tumor vaccines and gene therapy may play an important role in cancer treatment, but research into drug therapies should not be abandoned in the meantime.

Innovations, Cancer, Chemotherapy

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