Conclusions  Prior history of incarceration does not appear to impact primary care office-based treatment of opioid dependence with buprenorphine/naloxone.
Community health care providers can be reassured that initiating buprenorphine/naloxone in opioid dependent individuals with
a history of incarceration will have similar outcomes as those without this history.

Content Type Journal ArticleCategory Original ArticleDOI 10.1007/s11606-010-1306-0Authors
Emily A. Wang, Yale University School of Medicine Department of Internal Medicine New Haven CT USABrent A. Moore, Yale University School of Medicine Department of Psychiatry New Haven CT USALynn E. Sullivan, Yale University School of Medicine Department of Internal Medicine New Haven CT USADavid A. Fiellin, Yale Univers…

In conclusion, buprenorphine overdose causes an opioid syndrome clinically indistinguishable from heroin and methadone. Although mental status and respiratory depression are often unresponsive to low-dose naloxone, flumazenil may be effective in buprenorphine overdoses involving benzodiazepines. (Source: Journal of Substance Abuse Treatment)

Abstract  HIV-infected prisoners fare poorly after release. Though rarely available, opioid agonist therapy (OAT) may be one way to
improve HIV and substance abuse treatment outcomes after release. Of the 69 HIV-infected prisoners enrolled in a randomized
controlled trial of directly administered antiretroviral therapy, 48 (70%) met DSM-IV criteria for opioid dependence. Of these,
30 (62.5%) selected OAT, either as methadone (N = 7, 14.5%) or buprenorphine/naloxone (BPN/NLX; N = 23, 48.0%). Twelve-week HIV and substance abuse treatment outcomes are reported as a sub-study for those selecting BPN/NLX.
Retention was high: 21 (91%) completed BPN/NLX induction and 17 (74%) remained on BPN/NLX after 12 weeks. Compared with baseline,
the proportion with a non-detectab…

This article reviews the main pharmacotherapies that are currently being used to treat opioid addiction. Treatments include
detoxification using tapered methadone, buprenorphine, adrenergic agonists such as clonidine and lofexidine, and forms of
rapid detoxification. In opioid maintenance treatment (OMT), methadone is most widely used. OMT with buprenorphine, buprenorphine-naloxone
combination, or other opioid agonists is also discussed. The use of the opioid antagonists naloxone (for the treatment of
intoxication and overdose) and oral and sustained-release formulations of naltrexone (for relapse prevention) is also considered.
Although recent advances in the neurobiology of addictions may lead to the development of new pharmacotherapies for the treatment
of addictive disorders, a m…

Abstract: The National Institute on Drug Abuse Clinical Trials Network launched the Prescription Opioid Addiction Treatment Study (POATS) in response to rising rates of prescription opioid dependence and gaps in understanding the optimal course of treatment for this population. POATS employed a multi-site, two-phase adaptive, sequential treatment design to approximate clinical practice. The study took place at 10 community treatment programs around the United States. Participants included men and women age ≥18 who met Diagnostic and Statistical Manual, 4th Edition criteria for dependence upon prescription opioids, with physiologic features; those with a prominent history of heroin use (according to pre-specified criteria) were excluded. All participants received buprenorphine/naloxone (b…

Authors: Gunderson EW, Wang XQ, Fiellin DA, Bryan B, Levin FR
Physician adoption of buprenorphine treatment of opioid dependence may be limited in part by concerns regarding the induction process. Although national guidelines recommend observed induction, some physicians utilize unobserved induction outside the office. The aim of this pilot randomized clinical trial was to assess preliminary safety and effectiveness of unobserved versus observed office buprenorphine/naloxone induction among patients entering a 12-week primary care maintenance study. Participants (N=20) with DSM-IV opioid dependence were randomly assigned to unobserved or office induction, stratifying by past buprenorphine use. All patients received verbal and written instructions. A withdrawal scale was used during ini…

Along with teaching and telling stories, part of my goal here at All About Addiction is to get important information out to those who can benefit from it. Most drug users who quit drug use “cold turkey” have to go through withdrawal of some sort. Withdrawal is never comfortable, but sometimes it can actually be dangerous. The list below outlines some drugs that should NEVER be quit suddenly without medical supervision. This is the reason why some rehab treatment is preceeded by a medical detox period lasting anywhere from 2 days to a week or more. Which withdrawals can actually kill? Alcohol – Yes, after long term use, withdrawal from alcohol can kill. Alcohol withdrawal syndrome can take on mild, moderate, or severe forms. If while withdrawing from alcohol a person develops a fever, …