Substance use of disorders in HIV-infected patients: impact and new treatment strategies.

Substance use of disorders--including alcohol, cocaine, and opiod dependencies--are common in HIV-infected patients. Untreated substance use disorders result in poor HIV disease treatment outcomes; however, several new treatment strategies have emerged in recent years. Combined medication and counseling therapies are effective for alcohol and opioid dependencies, and counseling treatments are effective for cocaine dependence. Office-based treatment with buprenorphine offers the opportunity for coordinated treatment of HIV disease and opioid dependence. This article summarizes a presentation by David A. Fiellin, MD, in March 2004 at the International AIDS Society-USA New York course.