Reversal of central sleep apnoea with change from methadone to buprenorphine-naloxone: a case report

Preventing prescription opioid poisoning deaths is a major public health priority in Western societies. Deaths from these medications exceed deaths from all illicit drugs combined [1]. Methadone (for pain treatment) is involved in one third of US prescription opioid overdose deaths despite accounting for only 5% of dispensed opioids [2]. There is a dose-dependent increase in the severity of central sleep apnoea (CSA) with methadone [3–5] and sleep disordered breathing is a contributing factor in methadone-related deaths [2]. The partial μ-agonist buprenorphine is putatively safer than methadone with a ceiling effect upon respiratory depression [6]. However, the effect of buprenorphine on breathing during sleep remains unclear. The only relevant report from a cross-sectional observ…

Reversal of central sleep apnoea with change from methadone to buprenorphine-naloxone: a case report

Preventing prescription opioid poisoning deaths is a major public health priority in Western societies. Deaths from these medications exceed deaths from all illicit drugs combined [1]. Methadone (for pain treatment) is involved in one third of US prescription opioid overdose deaths despite accounting for only 5% of dispensed opioids [2]. There is a dose-dependent increase in the severity of central sleep apnoea (CSA) with methadone [3–5] and sleep disordered breathing is a contributing factor in methadone-related deaths [2]. The partial μ-agonist buprenorphine is putatively safer than methadone with a ceiling effect upon respiratory depression [6]. However, the effect of buprenorphine on breathing during sleep remains unclear. The only relevant report from a cross-sectional observ…

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Reversal of central sleep apnoea with change from methadone to buprenorphine-naloxone: a case report

Preventing prescription opioid poisoning deaths is a major public health priority in Western societies. Deaths from these medications exceed deaths from all illicit drugs combined [1]. Methadone (for pain treatment) is involved in one third of US prescription opioid overdose deaths despite accounting for only 5% of dispensed opioids [2]. There is a dose-dependent increase in the severity of central sleep apnoea (CSA) with methadone [3–5] and sleep disordered breathing is a contributing factor in methadone-related deaths [2]. The partial μ-agonist buprenorphine is putatively safer than methadone with a ceiling effect upon respiratory depression [6]. However, the effect of buprenorphine on breathing during sleep remains unclear. The only relevant report from a cross-sectional observ…

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Barriers to Primary Care Physicians Prescribing Buprenorphine

Reports on a study of physicians in the State of Washington who participated in a Rural Opioid Addiction Management Project on the use of buprenorphine-naloxone in the treatment of opioid use disorders. Study determined the percentage of physicians who prescribed this treatment, the characteristics associated with the prescribing physicians, the number of patients treated, and the barriers found when integrating this treatment into their outreach practice. (Source: Rural publications via the Rural Assistance Center)

MedWorm Sponsor Message: Directory of the best January Sales in the UK. Find the best Christmas presents too.

Barriers to Primary Care Physicians Prescribing Buprenorphine

Reports on a study of physicians in the State of Washington who participated in a Rural Opioid Addiction Management Project on the use of buprenorphine-naloxone in the treatment of opioid use disorders. Study determined the percentage of physicians who prescribed this treatment, the characteristics associated with the prescribing physicians, the number of patients treated, and the barriers found when integrating this treatment into their outreach practice. (Source: Rural publications via the Rural Assistance Center)

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Mom Uses Selfie To Help Break Down Mental Health Stigma

When mom Erin Jones posted a selfie with her prescriptions for antidepressants and anti-anxiety medication on Facebook, she inspired a social media movement to help break down the taboo surrounding mental illness. On Sept. 2, Jones — who blogs about being on the Autism spectrum and raising kids with special needs at Mutha Lovin’ Autism – shared this photo on her website’s Facebook page, along with a message about seeking treatment.  “I have tried living this life without prescription help,” she wrote in the caption. “It seems to have me on top of the world one minute and rocking in the corner the next. There is no consistency. I’m done with that. Anxiety and antidepressant medication to the rescue. Sometimes, folks, we just need help.”   The post has over 800 li…

Mom Uses Selfie To Help Break Down Mental Health Stigma

When mom Erin Jones posted a selfie with her prescriptions for antidepressants and anti-anxiety medication on Facebook, she inspired a social media movement to help break down the taboo surrounding mental illness. On Sept. 2, Jones — who blogs about being on the Autism spectrum and raising kids with special needs at Mutha Lovin’ Autism – shared this photo on her website’s Facebook page, along with a message about seeking treatment.  “I have tried living this life without prescription help,” she wrote in the caption. “It seems to have me on top of the world one minute and rocking in the corner the next. There is no consistency. I’m done with that. Anxiety and antidepressant medication to the rescue. Sometimes, folks, we just need help.”   The post has over 800 li…

Memantine improves buprenorphine/naloxone treatment for opioid dependent young adults

Opioid use disorders are considered a serious public health problem that is associated with increased morbidity and mortality (Degenhardt et al., 2014; Im et al., 2015; Larney et al., 2015; Yokell et al., 2014). While the recent rate of heroin use in the general population has remained relatively stable, with perhaps even some slight reduction in the use of prescription opioids among 12th graders in 2014 (Johnston et al., 2015), the last-year prevalence of heroin (∼0.7%, MTF) and prescription opioid use (8.8%, NSDUH) among young adults is disproportionately elevated (Johnston et al., 2014; SAMHSA, 2014). (Source: Drug and Alcohol Dependence)

Memantine improves buprenorphine/naloxone treatment for opioid dependent young adults

Opioid use disorders are considered a serious public health problem that is associated with increased morbidity and mortality (Degenhardt et al., 2014; Im et al., 2015; Larney et al., 2015; Yokell et al., 2014). While the recent rate of heroin use in the general population has remained relatively stable, with perhaps even some slight reduction in the use of prescription opioids among 12th graders in 2014 (Johnston et al., 2015), the last-year prevalence of heroin (∼0.7%, MTF) and prescription opioid use (8.8%, NSDUH) among young adults is disproportionately elevated (Johnston et al., 2014; SAMHSA, 2014). (Source: Drug and Alcohol Dependence)

Treatment outcomes in opioid dependent patients with different buprenorphine/naloxone induction dosing patterns and trajectories.

CONCLUSIONS: BUP induction dosing was guided by an objective measure of opioid withdrawal. Participants with higher baseline COWS whose BUP doses were raised more quickly were less likely to drop out in the first 7 days than those whose doses were raised slower.
SCIENTIFIC SIGNIFICANCE: This study supports the use of an objective measure of opioid withdrawal (COWS) during BUP induction to improve retention early in treatment. (Am J Addict 2015;XX:XX-XX).
PMID: 26400835 [PubMed – as supplied by publisher] (Source: American Journal on Addictions)