Diffusion of substance abuse treatment: will buprenorphine be a success?

摘要

The availability of buprenorphine promises to return the treatment of heroin addiction to mainstream medicine in the United States for the first time in nearly a century. This new treatment also provides an opportunity to reflect on the introduction of methadone and LAAM and their subsequent successes and failures in clinical implementation. The three articles that follow in this issue highlight the potential pharmacological, clinical, and logistic advantages of buprenorphine and provide clinicians with guidelines for its use in an integrated treatment setting. The clinical success of buprenorphine, however, depends in large part on factors beyond its pharmacological advantages. Clinician attitude and the extent to which they embrace buprenorphine will play an important role in determining the future success of this medication.