buprenorphine Archives

The Authors’ Own Words: Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?

Nov 15, 2019 by AMERSA

The Authors’ Own Words:

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.

Demystifying buprenorphine misuse: Has fear of diversion gotten in the way of addressing the opioid crisis?

Molly Doernberg BA; Noa Krawczyk BA; Deborah Agus JD; & Michael Fingerhood MD

Substance Abuse Vol. 40, Iss. 2, 2019

“Buprenorphine is proven to be a safe and highly effective medication treatment for opioid disorder, yet a misguided perception that it is prone to diversion results in increased stigma and an overly restrictive regulatory climate. The limitations placed on access to treatment can have dangerous and even fatal consequences. This manuscript reviews literature showing that illicit buprenorphine is often used for self-treatment among persons who are not accessing formal care and argues that we should work to make it more accessible, especially among criminal justice populations that are often denied any medication treatment. It is intended that this manuscript will encourage clinicians, treatment programs, funding agencies, and criminal justice bodies to focus on lowering barriers to legal buprenorphine and to improving quality of care, thus reducing the burden of overdose death in our communities.“

The Authors’ Own Words: The Problem of Pain: Additive Analgesic Effect of Tramadol and Buprenorphine in a Patient with Opioid Use Disorder

Nov 14, 2019 by AMERSA

The Authors’ Own Words:

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.

The Problem of Pain: Additive Analgesic Effect of Tramadol and Buprenorphine in a Patient with Opioid Use Disorder

Cristina Montalvo, MD, MBS; Nicolas Genovese, BA; & John Renner, MD

Substance Abuse Vol. 40, Iss. 2, 2019

“The treatment of severe pain in patients on long term buprenorphine therapy for opioid dependence remains an ongoing challenge for clinicians across the country. When non-pharmacological and non-opioid treatments prove ineffective, additional opioid medication is often the last remaining option for these patients. However, due to the traditional understanding of buprenorphine’s pharmacokinetics and its strong affinity for analgesic opioid receptors, the efficacy of any additional opioid medication chosen by clinicians would expectedly be reduced. Coupled with the dearth of academic literature examining appropriate adjuvant medication for those on buprenorphine treatment, this decision facing many clinicians begins to seem insurmountable. In this manuscript, we show that our patient had a significant decrease in his pain and an improvement in his daily functioning with the addition of tramadol to his medication regiment while maintained on his opioid agonist therapy, and it highlights a novel and effective treatment option available to clinicians in the management of pain for those on buprenorphine therapy. Further, our manuscript creates a paradigm for future studies to compare tramadol’s efficacy in pain management compared to other opioid and non-opioid analgesics for those on long-term buprenorphine therapy.“

The Authors’ Own Words: Interest in prescribing buprenorphine among resident and attending physicians at an urban teaching clinic.

Nov 8, 2019 by AMERSA

The Authors’ Own Words:

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.

Interest in prescribing buprenorphine among resident and attending physicians at an urban teaching clinic

Jocelyn R. James, MD; Leah M. Gordon, MD, MPH; Jared W. Klein, MD, MPH; Joseph O. Merrill , MD, MPH; Judith I. Tsui , MD, MPH

Substance Abuse Vol. 40, Iss. 1, 2019

“This academic medical center based study on attitudes toward buprenorphine maintenance treatment for opioid use disorder suggests that internal medicine physicians, especially those who are younger and who believe that buprenorphine is effective, have high interest in becoming waivered to prescribe buprenorphine. Integrating buprenorphine education, training, and waiver opportunities into residency programs may create a pipeline of buprenorphine providers and thereby expand access to effective opioid use disorder treatment.”