ABSTRACT
This chapter provides a historical overview and an update on prevalence and new theories about opiate use and abuse. Opiate addiction poses special diagnostic and treatment problems for the physician. The prevalence of narcotic abuse for the induction of euphoria is difficult to estimate, but the estimated prevalence of narcotic addiction is three to five times that of schizophrenia. The presence of both agonists and pure antagonists for opiate action suggested the possibility of opiate receptors in the body. The incidence of psychosis, usually schizophrenic reactions, in opiate addicts has been estimated from as low as 1% to as high as 19%. Abuse of alcohol by recently opiate-detoxified patients or patients maintained on methadone has been recognized as a serious problem since the early 1970s. The clinical use of clonidine for rapid, nonopiate detoxification has since become widespread with verification of its efficacy from all independent investigators who have studied its effects.
