Special Considerations and Clinical Management of HIV-Infected Drug Users

  • Author: Frederick L. Altice, MD (More Info)
  • Editors in Chief: Daniel R. Kuritzkes, MD; Joseph J. Eron, Jr., MD
  • Last Reviewed: 4/1/16 (What's New)

Summary

    Medically Supervised Opioid Withdrawal
    • Gradual taper using methadone or buprenorphine is the best-supported method for withdrawing from opioids[SAMHSA 2006]
    • Supervised opioid withdrawal without chronic opioid substitution therapy should be reserved for short-term opioid users (less than 2 years), young adults, and noninjectors[Mattick 2003a; Amato 2004]
    Pharmacotherapy for Opioid Dependence
    • Most effective chronic treatment for opioid addiction for long-term opioid-dependent patients, particularly PWIDs, is opioid substitution therapy,[Amato 2008; Mattick 2009] although data also supports use of extended-release naltrexone[Krupitsky 2011; Baser 2011]
    • Methadone
        Buprenorphine
          Naltrexone

        Action required