Aims: Prescription opioid (PO) dependence frequently co-occurs with chronic pain. Prior studies did not find poorer buprenorphine-naloxone (BUP-NLX) outcomes in chronic pain patients, but more dynamic indicators of chronic pain may impact treatment. We hypothesized that greater pain volatility would predict opioid use during BUP-NLX taper in adults with PO dependence and chronic pain. (Source: Drug and Alcohol Dependence)

(Source: Alcoholism and Drug Abuse Weekly)

(Source: Alcoholism and Drug Abuse Weekly)

CONCLUSIONS: Buprenorphine/naloxone was well tolerated in most adolescent patients, besides clinically nonsignificant liver enzyme elevations. Psychotropic medications may have been associated with the liver enzyme changes early in the course of treatment. Nevertheless, given the relatively small number of adolescents studied to date with buprenorphine/naloxone, additional studies evaluating liver enzymes in young patients receiving buprenorphine/naloxone (and no other psychotropics) are needed.
PMID: 25490611 [PubMed – in process] (Source: The American Journal of Drug and Alcohol Abuse)

CONCLUSIONS: Buprenorphine/naloxone was well tolerated in most adolescent patients, besides clinically nonsignificant liver enzyme elevations. Psychotropic medications may have been associated with the liver enzyme changes early in the course of treatment. Nevertheless, given the relatively small number of adolescents studied to date with buprenorphine/naloxone, additional studies evaluating liver enzymes in young patients receiving buprenorphine/naloxone (and no other psychotropics) are needed.
PMID: 25490611 [PubMed – in process] (Source: The American Journal of Drug and Alcohol Abuse)

Authors: Zamani N, Hassanian-Moghaddam H, Hossein Bayat A, Haghparast A, Shadnia S, Rahimi M, Demaneh BH
Abstract
The method of choice for reversal of opioid-toxicity is administration of naloxone. This treatment can be accompanied by complications including acute lung-injury, myocardial infarction, or withdrawal-syndrome (in dependent-patients). We aimed to evaluate the efficacy of buprenorphine in reversal of opioid-overdose syndrome in dependent-rats. A prospective case-control study was designed, in which a total of 30 rats were put on opioid-dependency protocol with 10mg/kg of intra-peritoneal morphine twice daily for 10 days. After confirmation of dependency by naloxone administration, the rats were overdosed by giving 16mg/kg of intra-peritoneal methadone. They were divided …

The United Kingdom Drug Strategy emphasises recovery as a key focus in the treatment of drug dependence. A framework for recovery is defined in the Recovery-Orientated Drug Treatment report, written by an expert working group, and comprises four key phases: engagement and stabilisation, including the establishment of treatment goals; preparation for change, involving engagement in psychosocial and pharmacological interventions; active change, including detoxification and medical withdrawal; and completion, including interventions that strengthen community integration. A body of evidence supports the benefits of buprenorphine, a partial agonist at mu opioid receptors, in supporting individualised recovery based on this framework, specifically in relation to the potential for rapid stabilisa…

The United Kingdom Drug Strategy emphasises recovery as a key focus in the treatment of drug dependence. A framework for recovery is defined in the Recovery-Orientated Drug Treatment report, written by an expert working group, and comprises four key phases: engagement and stabilisation, including the establishment of treatment goals; preparation for change, involving engagement in psychosocial and pharmacological interventions; active change, including detoxification and medical withdrawal; and completion, including interventions that strengthen community integration. A body of evidence supports the benefits of buprenorphine, a partial agonist at mu opioid receptors, in supporting individualised recovery based on this framework, specifically in relation to the potential for rapid stabilisa…

Authors: Balhara YP
PMID: 24380101 [PubMed – indexed for MEDLINE] (Source: Journal of Opioid Management)

CONCLUSION: Based on this experience, the protocol recommends Bup/Nx for pain only when baseline opioid doses are within bounds that reduce AEs at transition and incorporates dose flexibility to further reduce risks. This protocol warrants further testing.
PMID: 23264315 [PubMed – indexed for MEDLINE] (Source: Journal of Opioid Management)