You are seeing this message because your Web browser does not support basic Web standards. Find out more about why this message is appearing and what you can do to make your experience on this site better.


ABOUT JAMA
Advanced Search

Welcome   | My Account | E-mail Alerts | Access Rights | Sign In


  Vol. 295 No. 8, February 22, 2006 TABLE OF CONTENTS
  JAMA
  •  Online Features
  Letters
 This Article
 •Full text
 •PDF
 •Send to a friend
 • Save in My Folder
 •Save to citation manager
 •Permissions
 Citing Articles
 •Contact me when this article is cited
 Related Content
 •Related articles
 •Similar articles in JAMA
 Topic Collections
 •Anesthesia
 •Substance Abuse/ Alcoholism
 •Alert me on articles by topic
 Social Bookmarking
  Add to CiteULike Add to Connotea Add to Del.icio.us Add to Digg Add to Reddit Add to Technorati Add to Twitter What's this?

Detoxification and Treating Opioid Dependence—Reply

Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

In Reply: Dr Contreras raises an important point concerning the concept and term of "dependence," as it applies to patients with chronic pain who are treated with opioid analgesics. The DSM-IV diagnosis of substance dependence is based on "a maladaptive pattern of substance use," as manifested by the presence of 3 (or more) of 7 criteria.1 One criterion is "dependence," as evidenced by the occurrence of a withdrawal syndrome when a substance is withdrawn. Another is "tolerance," the need for increased amounts of a substance to achieve a desired effect, or diminished effect with continued use of the same amount. The other 5 DSM-IV criteria include taking larger amounts of a substance than intended, unsuccessful efforts to control use, a great deal of time spent in activities to obtain a substance, the reduction of important activities, and persistent use despite known substance-related physical or psychological problems.

The DSM-IV criteria do . . . [Full Text of this Article]

Patrick G. O’Connor, MD, MPH
patrick.oconnor@yale.edu
Section of General Internal Medicine
Department of Internal Medicine
Yale University School of Medicine
New Haven, Conn



Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter     What's this?

RELATED ARTICLES

Detoxification and Treating Opioid Dependence
Jose A. Contreras
JAMA. 2006;295(8):886-887.
EXTRACT | FULL TEXT  

Detoxification and Treating Opioid Dependence
Catherine J. de Jong
JAMA. 2006;295(8):887.
EXTRACT | FULL TEXT  

Anesthesia-Assisted vs Buprenorphine- or Clonidine-Assisted Heroin Detoxification and Naltrexone Induction: A Randomized Trial
Eric D. Collins, Herbert D. Kleber, Robert A. Whittington, and Nicole E. Heitler
JAMA. 2005;294(8):903-913.
ABSTRACT | FULL TEXT  

Methods of Detoxification and Their Role in Treating Patients With Opioid Dependence
Patrick G. O’Connor
JAMA. 2005;294(8):961-963.
EXTRACT | FULL TEXT  






HOME | CURRENT ISSUE | PAST ISSUES | TOPIC COLLECTIONS | CME | SUBMIT | SUBSCRIBE | HELP
CONDITIONS OF USE | PRIVACY POLICY | CONTACT US | SITE MAP
 
© 2006 American Medical Association. All Rights Reserved.