title: Opioid Use in the Twenty First Century: Similarities and Differences Across National Borders.
abstract: The global prevalence in the use of opiates and opioids has remained stable, though there were some unprecedented recent increases in opioid use and associated mortality and morbidity in the United States. Internationally, there is a strong tendency for consolidation of drug treatment strategies in favor of more systematic, structured and balanced approaches to regional and national drug policies. However, there are considerable differences in the scope, focus, and implementation of national drug policies and the political context is shaping drug prevention, treatment and rehabilitation efforts to an extent not typically observed in other public health domains. As a result, though in theory, there is a considerable multi-national agreement about the efficacy and effectiveness of different treatment modalities for opioid dependence, in practice, there are striking differences among different world regions and countries in the degree of implementation of these treatment modalities into clinical practice. Such discrepancies between theory and practice are observed even in high-income countries such as the United States and European Union member states, where evidence-based treatment modalities are still not well implemented into clinical practice. Despite the lack of evidence-based support for the role of detoxification as a stand-alone treatment for opioid use disorders, it appears to be the most widely used intervention for opioid use across the world.
authors: Bulgarian Addictions Institute, 93 Antim I, Sofia 1303, Bulgaria, Tel: 00359 885 000 533.
authors: Georgi
authors: G
authors: Vasilev
authors: University Hospital Sveta Marina, 1 Hristo Smirnenski blvd, Varna 9100, Bulgaria, Tel: 00359 889 317 293.
authors: Svetla
authors: S
authors: Milcheva
authors: Department of Psychiatry, Virginia Commonwealth University, 203 E. Cary Street, Richmond VA 23219, USA, Tel: 804 828 5807.
authors: Jasmin
authors: J
authors: Vassileva
keywords: drug policy; international; opioids; treatment