January 11, 2011
Opioid Maintenance: Terminable vs. Interminable
Herbert D. Kleber, MD
Professor of Psychiatry, Columbia University
Director, Division on Substance Abuse
New York State Psychiatric Institute
Maintenance vs. Detoxification and Short Term vs. Long Term Maintenance are debates that have gone on for over 100 years. These concerns had been of more interest recently with the introduction of buprenorphine for office –based practice and the entry of many new clinicians into the opioid addiction treatment field. The growing number of buprenorphine patients, including younger individuals with relatively short histories of opioid abuse, present new challenges for the clinician. One major problem is the relative lack of scientific data on the efficacy of maintenance treatment in this population. This presentation will trace the historical roots of the conflict, the relationship to stigma, and the scientific data supporting the positions. Where available, patient selection data will be described.
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