We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Buprenorphine-Naloxone Treatment in Physicians and Nurses With Opioid Dependence
María Dolores Braquehais , Christian Fadeuilhe , Anders Håkansson , Miquel Jordi Bel , María Cecilia Navarro , Carlos Roncero , Eugeni Bruguera , Miquel Casas
Substance Abuse
Vol. 36, Iss. 2, 2015

Opioid maintenance treatment in physicians returning to work has been debated and data on this type of treatment for opioid–dependence in health professionals are lacking. Although buprenorphine-naloxone treatment is well-documented in other groups of patients, this work is – to the best of the authors’ knowledge – the first description of cases where physicians or nurses with opioid-dependence are treated with buprenorphine-naloxone maintenance. Our findings suggest that maintenance treatment with buprenorphine-naloxone may be a feasible and an effective option in the treatment of health care professionals with opioid dependence. Its benefits on cognitive functioning compared to methadone should be considered in this specific professional group aiming to go back to work. Our preliminary experience suggests further systematic and controlled trials to prove the benefits of this treatment in this specific patient group.

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Adherence to Buprenorphine Treatment Guidelines in a Medicaid Program
Jeffrey D. Baxter , Robin E. Clark , Mihail Samnaliev , Gideon Aweh , Elizabeth O’Connell
Substance Abuse
Vol. 36, Iss. 2, 2015

This is the first study to investigate the structure of buprenorphine treatment on a large scale across multiple providers and clinical practice sites. Our findings suggest there is significant variation in practice patterns, and that many patients receive care outside of the levels recommended by current treatment guidelines.

Now after more than 10 years experience with office-based buprenorphine treatment, providers and policy makers are at a crossroads. With opioid abuse and overdose rates increasing, federal agencies are weighing expanding the buprenorphine prescribing limits to try to improve access. At the same time, states and private payers are imposing restrictions on treatment without understanding the potential impact of limiting access on patients’ lives and on healthcare costs.

In order to sustain and expand this modality, it is critically important create policies that ensure buprenorphine treatment is provided in the highest quality, most cost effective manner. We hope that our findings support work on updating treatment guidelines and developing quality metrics that will encourage both providers and payers to invest further in providing high quality treatments for opioid addiction.

We ask authors to describe their impressions regarding the implications of their accepted work, how their findings will change practice, and what is noteworthy about the work.

Defining Nonmedical Use of Prescription Opioids Within Health Care Claims: A Systematic Review
Gerald Cochran, Bongki Woo, Wei-Hsuan Lo-Ciganic, Adam J. Gordon,  Julie M. Donohue, Walid F. Gellad
Substance Abuse
Vol. 36, Iss. 2, 2015

Health insurance claims data may play an important role for healthcare systems and payers in monitoring the non-medical use of prescription opioids (NMPO) among patients. We conducted a systematic review of publications that defined and measured NMPO within health insurance claims databases in order to describe definitions of NMPO and identify areas for improvement. Findings showed substantial variation in: conceptual and operational definitions of NMPO, efforts to validate these definitions, and rates of NMPO. Future research should prospectively test and validate a construct of NMPO to disseminate to payers and health officials.