Special Considerations and Clinical Management of HIV in Patients With Substance Use Disorder

  • Author: Frederick L. Altice, MD (More Info)
  • Editors in Chief: Joseph J. Eron, Jr., MD; Daniel R. Kuritzkes, MD
  • Last Reviewed: 2/5/20 (What's New)

Summary

  • Most effective chronic treatment for opioid addiction for patients with long-term opioid-dependence, particularly PWIDs, is opioid substitution therapy,[Amato 2008; Mattick 2009] although data also supports use of extended-release naltrexone[Krupitsky 2011; Baser 2011]
  • Patients receiving agonist therapy should be enrolled in a comprehensive drug treatment program
  • Methadone
    • Methadone maintenance has been shown to decrease the psychosocial and medical morbidity associated with opioid dependence, improve overall health status, decrease criminal activity and improve social functioning, and decrease HIV transmission among PWIDs[Amato 2005]
    Buprenorphine
      Naltrexone
        Clonidine

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