ConclusionsDespite prison being a highly regulated and controlled environment, some level of diversion and sharing of psychoactive medication occurs among prisoners. The buprenorphine formulations used in OST present particular challenges with respect to supervised dosing in this setting. [White N, Ali R, Larance B, Zador D, Mattick RP, Degenhardt L. The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine–naloxone film. Drug Alcohol Rev 2015;●●:●●–●●] (Source: Drug and Alcohol Review)

CONCLUSION: Buprenorphine-naloxone maintenance treatment can be associated with sleep-disordered breathing. It can be difficult to differentiate the cause(s) of sleep-disordered breathing among the effects of buprenorphine-naloxone treatment itself, co-occurring conditions, such as obesity and cigarette smoking or other medications, or some combination thereof. Regardless of etiology, sleep-disordered breathing and its consequences present unique challenges to the patient in recovery from an opioid use disorder and therefore warrants careful evaluation and management.
PMID: 26312963 [PubMed – as supplied by publisher] (Source: Journal of Opioid Management)

CONCLUSION: Buprenorphine-naloxone maintenance treatment can be associated with sleep-disordered breathing. It can be difficult to differentiate the cause(s) of sleep-disordered breathing among the effects of buprenorphine-naloxone treatment itself, co-occurring conditions, such as obesity and cigarette smoking or other medications, or some combination thereof. Regardless of etiology, sleep-disordered breathing and its consequences present unique challenges to the patient in recovery from an opioid use disorder and therefore warrants careful evaluation and management.
PMID: 26312963 [PubMed – as supplied by publisher] (Source: Journal of Opioid Management)

To the Editor In the article about emergency department (ED)–initiated buprenorphine/naloxone treatment for opioid dependence, Dr D’Onofrio and colleagues omitted important information and then focused on the most optimistic outcomes to infer a benefit. (Source: JAMA)

To the Editor In the article about emergency department (ED)–initiated buprenorphine/naloxone treatment for opioid dependence, Dr D’Onofrio and colleagues omitted important information and then focused on the most optimistic outcomes to infer a benefit. (Source: JAMA)

To the Editor In the article about emergency department (ED)–initiated buprenorphine/naloxone treatment for opioid dependence, Dr D’Onofrio and colleagues omitted important information and then focused on the most optimistic outcomes to infer a benefit. (Source: JAMA)

To the Editor In the article about emergency department (ED)–initiated buprenorphine/naloxone treatment for opioid dependence, Dr D’Onofrio and colleagues omitted important information and then focused on the most optimistic outcomes to infer a benefit. (Source: JAMA)

This study examined pain trajectories and pain volatility in patients with chronic pain receiving treatment for prescription opioid addiction. We conducted secondary analyses of adults with chronic pain (n = 149) who received buprenorphine/naloxone (BUP/NLX) and counseling for 12 weeks in an outpatient, multisite clinical trial. Good treatment outcome was defined as urine-verified abstinence from opioids at treatment endpoint (Week 12) and during at least 2 of the previous 3 weeks. Pain severity significantly declined over time during treatment (b = −0.36, p < .001). Patients with greater pain volatility were less likely to have a good treatment outcome (odds ratio = 0.55, p < .05), controlling for baseline pain severity and rate of change in pain over time. A 1 standard deviation increa…

By Aaron Fox, M.D., M.S. Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison. Incarceration Undermines Recovery Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the attent…

By Aaron Fox, M.D., M.S.

Finally, Democrats and Republicans have agreed that reducing prison sentences should be a priority, especially for nonviolent drug offenses. It’s common sense that people with substance-use disorders should be offered addiction treatment as an alternative to incarceration. But what if they can’t stop using drugs? They still don’t belong in prison.

Incarceration Undermines Recovery
Incarceration is destabilizing and can set people back in their addiction recovery. In low-income communities, it leads to housing instability and unemployment, and strains the relationships with families necessary for recovery. Incarceration may also disrupt addiction treatment, which is like suspending a kid from school for truancy, thereby guaranteeing that child won’t get the att…