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Potential alternative opioids include long\u2010acting partial agonists such as buprenorphine and pure antagonists such as naltrexone. Buprenorphine is an alternative to methadone with intermediate intrinsic efficacy. It has a large margin of safety, yet displays some agonist actions similar to methadone. It has greater potential than methadone to safely and effectively block the actions of illicit opioids. Naltrexone is a safe, convenient opioid\u2010antagonist for use following detoxification from opioid agonists. Its main use is to block the actions of other opioids, thereby attenuating or eliminating illicit use during treatment. However, it is poorly accepted by many clients, limiting its application to a sub\u2010group who are highly motivated to detoxify. The distinct pharmacological properties of these opioids can overcome some of the drawbacks of methadone, but other limitations may emerge. Non\u2010opioid adjuncts such as \u03b12\u2010adrenoceptor agonists can also have a role during detoxification. These drugs might be of use for specific groups of opioid users, providing therapists with the flexibility to tailor pharmacotherapy to the individual needs of clients.<\/jats:p>","DOI":"10.1080\/09595239300185751","type":"journal-article","created":{"date-parts":[[2006,7,7]],"date-time":"2006-07-07T08:17:15Z","timestamp":1152260235000},"page":"71-80","update-policy":"http:\/\/dx.doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Pharmacological options for management of opioid dependence"],"prefix":"10.1111","volume":"12","author":[{"given":"Macdonald J.","family":"Christie","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna I.","family":"Harvey","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2009,5,29]]},"reference":[{"key":"e_1_2_1_2_2","volume-title":"Feasibility research into the controlled availability of opioids, 1 & 2","author":"National Centre for Epidemiology and Population Health","year":"1991"},{"key":"e_1_2_1_3_2","volume-title":"Heroin treatment\u2010 new alternatives","author":"Bammer G.","year":"1992"},{"key":"e_1_2_1_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595239100185261"},{"key":"e_1_2_1_5_2","first-page":"485","volume-title":"The pharmacological basis of therapeutics","author":"Jaffe JH","year":"1990"},{"key":"e_1_2_1_6_2","first-page":"197","article-title":"Methods in the study of opioids","volume":"39","author":"Leslie FM.","year":"1987","journal-title":"Pharmacol Rev"},{"key":"e_1_2_1_7_2","first-page":"158","volume-title":"Mechanisms of tolerance to opiates in locus coeruleus neurons","author":"Christie MJ","year":"1987"},{"key":"e_1_2_1_8_2","doi-asserted-by":"crossref","first-page":"2574","DOI":"10.1523\/JNEUROSCI.11-08-02574.1991","article-title":"Transient \u03bc\u2010opioid receptor homologous desensitization in rat locus coeruleus neurons","volume":"11","author":"Harris GC","year":"1991","journal-title":"J Neurosci"},{"key":"e_1_2_1_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1965.03090080008002"},{"key":"e_1_2_1_10_2","doi-asserted-by":"crossref","first-page":"304","DOI":"10.1001\/archinte.1966.00290160004002","article-title":"Narcotic blockade","volume":"118","author":"Dole VP","year":"1966","journal-title":"Arch Int Med"},{"key":"e_1_2_1_11_2","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1989.tb128472.x"},{"key":"e_1_2_1_12_2","doi-asserted-by":"publisher","DOI":"10.1080\/09595239000185281"},{"key":"e_1_2_1_13_2","doi-asserted-by":"publisher","DOI":"10.3109\/10826088509047756"},{"key":"e_1_2_1_14_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1973.01750320112017"},{"key":"e_1_2_1_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.211.11.1834"},{"key":"e_1_2_1_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/0740-5472(86)90021-8"},{"key":"e_1_2_1_17_2","first-page":"517","article-title":"The effects of morphine\u2010 and nalorphine\u2010like drugs in the non\u2010dependent and morphine\u2010dependent chronic spinal dog","volume":"197","author":"Martin WR","year":"1976","journal-title":"J Pharmacol Exp Ther"},{"key":"e_1_2_1_18_2","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1978.01770280111012"},{"key":"e_1_2_1_19_2","doi-asserted-by":"publisher","DOI":"10.1002\/cpt1970113385"},{"key":"e_1_2_1_20_2","first-page":"103","volume-title":"Advances in substance abuse: behavioral and biological research","author":"Lewis JW","year":"1982"},{"key":"e_1_2_1_21_2","first-page":"347","article-title":"Buprenorphine: beyond methadone","volume":"42","author":"Rosen MI","year":"1991","journal-title":"Hospital Commun Psychiat"},{"key":"e_1_2_1_22_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1989.66"},{"key":"e_1_2_1_23_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1988.13"},{"key":"e_1_2_1_24_2","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1990.67"},{"key":"e_1_2_1_25_2","first-page":"245","article-title":"The acute effects of high dose buprenorphine in non\u2010dependent humans. 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