Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review.

Authors: Yokell MA, Zaller ND, Green TC, Rich JD
Abstract
The diversion, misuse, and non-medically supervised use of buprenorphine and buprenorphine/naloxone by opioid users are reviewed. Buprenorphine and buprenorphine/naloxone are used globally as opioid analgesics and in the treatment of opioid dependency. Diversion of buprenorphine and buprenorphine/naloxone represents a complex medical and social issue, and has been widely documented in various geographical regions throughout the world. We first discuss the clinical properties of buprenorphine and its abuse potential. Second, we discuss its diversion and illicit use on an international level, as well as motivations for those activities. Third, we examine the medical risks and benefits of buprenorphine’s non-medically supervise…

Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review.

Authors: Yokell MA, Zaller ND, Green TC, Rich JD
Abstract
The diversion, misuse, and non-medically supervised use of buprenorphine and buprenorphine/naloxone by opioid users are reviewed. Buprenorphine and buprenorphine/naloxone are used globally as opioid analgesics and in the treatment of opioid dependency. Diversion of buprenorphine and buprenorphine/naloxone represents a complex medical and social issue, and has been widely documented in various geographical regions throughout the world. We first discuss the clinical properties of buprenorphine and its abuse potential. Second, we discuss its diversion and illicit use on an international level, as well as motivations for those activities. Third, we examine the medical risks and benefits of buprenorphine’s non-medically supervise…

Buprenorphine and buprenorphine/naloxone intoxication in children – how strong is the risk?

Authors: Soyka M
Abstract
Opioid maintenance therapy with methadone or buprenorphine is an established and first-line treatment for opioid dependence. Risk of diversion and toxicity of opioid prescription drugs, including buprenorphine, causes significant concerns. This is particularly the case in the United States, where the number of related emergency visits is increasing, especially in children. A systematic literature research (Medline, Pubmed) was performed to assess the risk associated with buprenorphine. The search, which was not limited to particular publication years, was performed with the key words buprenorphine AND toxicity (114 counts ) AND children (4 counts) and buprenorphine AND mortality AND children (5 counts). In addition, the author obtained information from rel…

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Complete Care Medical Center Now Offering Outpatient Detox Treatment…

Complete Care Medical Center is now offering outpatient detox treatment with several Certified Suboxone Doctors in South Florida. The treatment is highly effective for those suffering from addiction…(PRWeb November 11, 2014)Read the full story at http://www.prweb.com/releases/suboxone-doctors/south-florida/prweb12317157.htm (Source: PRWeb: Medical Pharmaceuticals)

Complete Care Medical Center Now Offering Outpatient Detox Treatment…

Complete Care Medical Center is now offering outpatient detox treatment with several Certified Suboxone Doctors in South Florida. The treatment is highly effective for those suffering from addiction…(PRWeb November 11, 2014)Read the full story at http://www.prweb.com/releases/suboxone-doctors/south-florida/prweb12317157.htm (Source: PRWeb: Medical Pharmaceuticals)

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Effect of Steady-State Faldaprevir on the Pharmacokinetics of Steady-State Methadone and Buprenorphine/Naloxone in Subjects on Stable Addiction Management Therapy.

In conclusion, faldaprevir 240 mg QD can be coadministered with methadone or buprenorphine/naloxone without dose adjustment, although given the relatively narrow therapeutic windows of these agents, monitoring for opiate overdose and withdrawal may still be appropriate Registered at ClinicalTrials.gov registration number: NCT01637922.
PMID: 25385094 [PubMed – as supplied by publisher] (Source: Antimicrobial Agents and Chemotherapy)

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Combined Abuse of Clonidine and Amitriptyline in a Patient on Buprenorphine Maintenance Treatment

Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating altered mental status, hallucinations, falls, and rebound hypertension was found to be concomitantly abusing clonidine and amitryptyline, which share metabolic pathways with buprenorphine. Clinicians should be aware of patients’ combining amitryptyline, clonidine, and gabapentin with buprenorphine to achieve a mood altering state, avoid co-prescribing them if possible, and maintain communication with pharmacies and other providers when they are prescribed. (Source: Journal of Addiction Medicine)

Group Medication Management for Buprenorphine/Naloxone in Opioid-Dependent Veterans

Conclusions:This study found that veterans prescribed buprenorphine/naloxone in a group setting as part of a drug and alcohol treatment program were retained in treatment longer than veterans prescribed this medication individually. Because of inherent limitations in the study design, no causality can be determined; however, given the results found here, group medication management of buprenorphine/naloxone should be explored further. (Source: Journal of Addiction Medicine)

Combined Abuse of Clonidine and Amitriptyline in a Patient on Buprenorphine Maintenance Treatment

Buprenorphine/naloxone maintenance therapy is often prescribed in primary care to treat opioid dependence. Previous reports have described concomitant abuse of opioids and clonidine. In this case, a primary care patient on buprenorphine/naloxone maintenance therapy demonstrating altered mental status, hallucinations, falls, and rebound hypertension was found to be concomitantly abusing clonidine and amitryptyline, which share metabolic pathways with buprenorphine. Clinicians should be aware of patients’ combining amitryptyline, clonidine, and gabapentin with buprenorphine to achieve a mood altering state, avoid co-prescribing them if possible, and maintain communication with pharmacies and other providers when they are prescribed. (Source: Journal of Addiction Medicine)

Group Medication Management for Buprenorphine/Naloxone in Opioid-Dependent Veterans

Conclusions:This study found that veterans prescribed buprenorphine/naloxone in a group setting as part of a drug and alcohol treatment program were retained in treatment longer than veterans prescribed this medication individually. Because of inherent limitations in the study design, no causality can be determined; however, given the results found here, group medication management of buprenorphine/naloxone should be explored further. (Source: Journal of Addiction Medicine)

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