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Clinical Crossroads
Clinician's Corner
July 16, 2008

A 50-Year-Old Woman Addicted to HeroinReview of Treatment of Heroin Addiction

Author Affiliations

Author Affiliations: Dr O’Brien is Kenneth E. Appel Professor of Psychiatry, Associate Director for Research, VA Mental Illness Research, Education and Clinical Center, and Vice Chairman, Department of Psychiatry, University of Pennsylvania, Philadelphia.

JAMA. 2008;300(3):314-321. doi:10.1001/jama.300.1.jrr80005

Heroin addiction is a complicated medical and psychiatric issue, with well-established as well as newer modes of treatment. The case of Ms W, a 50-year-old woman with a long history of opiate addiction who has been treated successfully with methadone for 9 years and who now would like to consider newer alternatives, illustrates the complex issues of heroin addiction. The treatment of heroin addiction as a chronic disease is reviewed, including social, medical, and cultural issues and pharmacologic treatment with methadone and the more experimental medication options of buprenorphine and naltrexone.