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)

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)

Medic 453 is dispatched for an unconscious female with a suspected narcotics overdose. In approximately four minutes, the EMTs reach a small, 1.5-story home and are met outside by two police officers. The officers enter the house and declare the scene to be secure and safe to enter.
The EMTs find a 40–45-year-old female unconscious and unresponsive on the floor of an upstairs bedroom. The patient’s boyfriend reports he found her about 15 minutes ago. The patient has a history of substance abuse—most recently heroin. The boyfriend claims she hasn’t been using heroin but is on Suboxone (buprenorphine and naloxone). No drug paraphernalia is found around the patient but track marks from prior use are evident on both arms.
The patient has shallow, labored breathing and no apparent traum…

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)

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)