Management of opioid dependence

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Abstract
Opioid dependence is a chronic relapsing disease that is difficult to cure, but stabilization and harm reduction can greatly increase the life expectancy and quality of life of patients, their direct environment and society as a whole. Purpose of the review The present review provides an overview of the most recent developments in the treatment of opioid-dependent patients, using a chronic disease model as a starting point, and taking crisis intervention, cure (detoxification, relapse prevention), care (stabilization and harm reduction) and palliation as the major treatment goals. Recent findings The various high-quality studies, systematic literature reviews and formal meta-analyses clearly demonstrate that, currently, many proven effective interventions are available for crisis intervention, detoxification, stabilization and harm reduction. Interventions directed at relapse prevention are still problematic and only effective in motivated patients in stable living conditions and with adequate social support. Treatment innovations are primarily based on experimental animal studies. Newly developed cannabinoid receptor antagonists and cortisol synthesis inhibitors show great promise.