The next set of chapters covers new developments in the optimization of the classic treatment modalities for opiate dependence—agonist maintenance with methadone, detoxification strategies, and antagonist maintenance with naltrexone. As well as updates on the latest research, these chapters also stand as good introductions to the treatment methods—for example, Stine’s discussion of the importance of dose, blood level, and awareness of potential drug interactions in the application of methadone maintenance. Particularly valuable is the critical stance maintained by the authors, such as Rosen’s frank discussion of the limitations of clonidine as a detoxification agent. Farren, O’Malley, and Rounsaville provide an excellent discussion of psychosocial treatment approaches that might be applied to make naltrexone maintenance more effective, as do Avants, Ohlin, and Margolin in their chapter on psychosocial treatments in methadone maintenance. The chapter on acupuncture highlights the surprising accumulation of evidence supporting this alternative treatment modality. In their chapter on the medical care of opiate addicts, O’Connor and Selwyn provide a welcome review for psychiatric clinicians who are increasingly called on to serve a primary care function of assessment and appropriate referral for HIV, viral hepatitis, and other serious medical problems common in opiate addicts.