Sublingual Buprenorphine

OPIOID-DEPENDENT PATIENTS present a unique perioperative care challenge. These patients are managed as outpatients in several different manners. The type of treatment that such patients receive can have a profound impact on their perioperative care when they present for surgery. One management option is the use of sublingual (SL) buprenorphine to treat opioid dependence. This drug is available as either Suboxone or Subutex (Reckitt Benckiser Pharmaceuticals, Inc, Richmond, VA). Subutex contains buprenorphine only, whereas Suboxone contains buprenorphine and naloxone to deter diversion to the injectable route (naloxone will precipitate opioid withdrawal if injected, but has no effect if taken sublingually or orally). As we shall see, the same properties that make buprenorphine effective in…

The prevalence and correlates of buprenorphine inhalation amongst opioid substitution treatment (OST) clients in Australia

Conclusions: Our data indicates that the inhalation of buprenorphine has occurred in a significant minority of Australian OST clients. The motivations, contexts and potential health consequences of buprenorphine use by these atypical routes of administration, particularly in a correctional setting, warrant further exploration. (Source: International Journal of Drug Policy)

N.Y. to Prescribe Suboxone for Ex-Prisoners

The state of New York plans to give some state prisoners the opiate-treatment drug Suboxone to help them stay off heroin upon release. (Source: Alcohol, Tobacco and Other Drugs News)

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Accidental and Non-Accidental Ingestion of Methadone and Buprenorphine in Childhood: A Single Center Experience, 1999-2009.

Conclusions: Accidental and non-accidental ingestion of methadone and buprenorphine by children is increasing in proportion to increased clinical use and availability. Health providers should be aware of this increased risk and be able to provide appropriate treatment and family support.
PMID: 21047302 [PubMed – as supplied by publisher] (Source: Current Drug Safety)

The Subjective, Reinforcing, and Analgesic Effects of Oxycodone in Patients with Chronic, Non-Malignant Pain who are Maintained on Sublingual Buprenorphine/Naloxone

The Subjective, Reinforcing, and Analgesic Effects of Oxycodone in Patients with Chronic, Non-Malignant Pain who are Maintained on Sublingual Buprenorphine/Naloxone

Neuropsychopharmacology advance online publication, October 27, 2010. doi:10.1038/npp.2010.172

Authors: Jermaine D Jones, Maria A Sullivan, Jeanne Manubay, Suzanne K Vosburg
& Sandra D Comer
Keywords: opioids; pain/analgesics; addiction & substance abuse; psychopharmacology; buprenorphine (Source: Neuropsychopharmacology)

Buprenorphine-based regimens and methadone for the medical management of opioid dependence: selecting the appropriate drug for treatment.

Authors: Maremmani I, Gerra G
Maintenance therapy with methadone or buprenorphine-based regimens reduces opioid dependence and associated harms. The perception that methadone is more effective than buprenorphine for maintenance treatment has been based on low buprenorphine doses and excessively slow induction regimens used in early buprenorphine trials. Subsequent studies show that the efficacy of buprenorphine sublingual tablet (Subutex®) or buprenorphine/naloxone sublingual tablet (Suboxone®) is equivalent to that of methadone when sufficient buprenorphine doses, rapid induction, and flexible dosing are used. Although methadone remains an essential maintenance therapy option, buprenorphine-based regimens increase access to care and provide safer, more appropriate treatment than met…

Buprenorphine Implants for Treatment of Opioid Dependence: A Randomized Controlled Trial [Original Contribution]

Conclusion  Among persons with opioid dependence, the use of buprenorphine implants compared with placebo resulted in less opioid use over 16 weeks as assessed by urine samples.
Trial Registration  clinicaltrials.gov Identifier: NCT00447564 (Source: JAMA)

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