G Recent Advances in Pharmacotherapy

GENERAL ISSUES

  • Creation of National Institute on Drug Abuse Medications Development Division to evaluate new treatments for opioid and cocaine addiction in animals and humans.

NICOTINE

  • Food and Drug Administration focuses on nicotine as an addictive drug; characterization of tobacco withdrawal syndrome.

  • Demonstration that nicotine replacement is an effective treatment modality for a small but significant population of smokers.

  • Nicotine chewing gum and transdermal nicotine patches approved for over-the-counter sale in 1996; nicotine nasal spray approved for prescription use in 1996; advances in other preparations.

  • Increased research on nicotine replacement therapies for extending nicotine abstinence and reducing craving.

  • Development of precise and practical measurements of nicotine metabolites, thus allowing better characterization of drug intake, dependence, and treatment outcome.

  • Demonstration that addicted smokers regulate intake of nicotine to maintain specific levels in the body.



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OCR for page 199
G Recent Advances in Pharmacotherapy GENERAL ISSUES Creation of National Institute on Drug Abuse Medications Development Division to evaluate new treatments for opioid and cocaine addiction in animals and humans. NICOTINE Food and Drug Administration focuses on nicotine as an addictive drug; characterization of tobacco withdrawal syndrome. Demonstration that nicotine replacement is an effective treatment modality for a small but significant population of smokers. Nicotine chewing gum and transdermal nicotine patches approved for over-the-counter sale in 1996; nicotine nasal spray approved for prescription use in 1996; advances in other preparations. Increased research on nicotine replacement therapies for extending nicotine abstinence and reducing craving. Development of precise and practical measurements of nicotine metabolites, thus allowing better characterization of drug intake, dependence, and treatment outcome. Demonstration that addicted smokers regulate intake of nicotine to maintain specific levels in the body.

OCR for page 199
OPIOIDS Approval of LAAM (levomethadyl acetate, Orlaam®) as 2 to 3 times per week treatment for opioid dependence. Evaluation of long-term methadone or LAAM therapy in reducing illicit opioid drug use in many patients. Evaluation of buprenorphine and other partial agonist compounds as safer replacements for methadone treatment. STIMULANTS Evaluation of catalytic antibodies for degrading or inactivating cocaine. Expanded evaluation of selective dopamine, serotonin, and opioid agonists and antagonists for cocaine addiction. Expanded examination of the concept of agonist replacement strategies and specific medications. ALCOHOL Naltrexone (ReVia™) approved for treatment of alcoholism in the United States. Acamprosate (Aotal®) approved for treatment of alcoholism in Europe, and gamma-hydroxybutyrate approved for treatment of alcoholism in Italy. Expanded research into use of serotonin reuptake inhibitors, opioid antagonists, serotonin 5-HT3 receptor antagonists, drug combinations, and other pharmacological treatments.