Buprenorphine - Articles - Page 3

Suboxone vs. Vivitrol for Opioid Use Disorder: How Do you Choose?

November 5, 2021

Gregory Lande, MD. Dr. Lande has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buprenorphine and long acting injectable naltrexone are both effective for the treatment of opioid use disorder; however, until now, we had little data to predict which patients would do better on which medications. Here, researchers identify patient characteristics predictive of success on buprenorphine versus naltrexone.

Starting Buprenorphine: Is Timing Everything?

July 3, 2021

John O’Neal, MD

John O’Neal, MD Dr. O’Neal has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

When is an optimal time to start buprenorphine in order to keep patients in treatment? In this retrospective study, researchers compared treatment retention as a function of whether or not buprenorphine was prescribed on the day of initial evaluation. Same day prescription trended non-significantly towards improved retention.

CLINICAL UPDATE

Perioperative Pain Management in Opioid Use Disorder

March 19, 2021

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Previously, clinicians commonly stopped opioid agonists (methadone and buprenorphine) to simplify pain control during and after surgery. New guidance from the American Society of Addiction Medicine now suggests otherwise.

Kratom: A Primer

February 3, 2021

Alison Knopf

Alison Knopf Editor, Alcoholism & Drug Abuse Weekly Ms. Knopf has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

With opioid-like properties, kratom’s recreational use is increasingly reported among those seeking pain relief or a high. This primer reviews what’s known about this unregulated substance, how to talk about it in the clinic, and early evidence on how to treat its withdrawal syndrome.

Supporting Patients With Pain and Addiction

February 3, 2021

Ajay Manhapra, MD

Ajay Manhapra, MD

Section Chief, Pain Medicine, Department of Physical Medicine & Rehabilitation Services, Hampton VA Medical Center. Assistant Professor, Departments of Physical Medicine & Rehabilitation and Psychiatry, Eastern Virginia Medical School, Norfolk, VA; Lecturer in Psychiatry, Yale School of Medicine, New Haven, CT. Dr. Manhapra has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Dr. Manhapra works with patients with disabling chronic pain, many of whom meet criteria for substance use disorders. He describes his approach to these intersecting phenomena, the biology of pain and its relationship to the reward system, and outlines an approach to improving function among patients with addiction and severe pain.

When to Stop Addiction Treatment: How Long Is Enough?

December 10, 2020

Michael Weaver, MD, FASAM.

Michael Weaver, MD, FASAM. Professor and medical director at the Center for Neurobehavioral Research on Addictions, University of Texas Medical School. Dr. Weaver has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Addiction is often lifelong phenomenon, but many patients may still wish to end treatment. We discuss the reasons why a patient might ask to “complete” their treatment and provide you with strategies for talking with patients about ceasing therapeutic treatments for substance use disorders.

EXPERT Q&A

Opioid Use Disorders and Serious Mental Illness

December 10, 2020

Sandra Gomez-Luna, MD

Sandra Gomez-Luna, MD
Clinical Assistant Professor at Yale University. Adult, adolescent, and child psychiatrist in Darien, CT. Dr. Gomez-Luna has disclosed that she has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Those with serious mental illness and unhealthy opioid use have special treatment considerations due to polypharmacy and overlapping stigma. Dr. Gomez-Luna walks us through these nuances and explains microdosing of buprenorphine—a helpful technique for starting treatment in patients who may have other opioids on board.

“What About the Implant, Doc?” Appraising Various Formulations of Buprenorphine

August 6, 2020

Edmund S. Higgins, MD.

Edmund S. Higgins, MD. Clinical Associate Professor of Psychiatry and Family Medicine, MUSC, Charleston, SC. Dr. Higgins has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buprenorphine can be administered via intravenous, transdermal, sublingual, buccal, and implanted formulations. We appraise the evidence for various formulations and suggest certain populations for which certain formulations may be a better choice.

Updated Guidelines for Treating Opioid Use Disorder

August 6, 2020

Rehan Aziz, MD.

Rehan Aziz, MD. Associate Professor of Psychiatry and Neurology, Rutgers Robert Wood Johnson Medical School. Dr. Aziz has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity

The American Society of Addiction Medicine released updated guidelines for the management of opioid use disorder (OUD) in March, 2020. They focus on expanding access to methadone and buprenorphine. Additionally, detailed guidance is given for perioperative management of OUD and pain management in patients with OUD.

SAMHSA Relaxes Regulations on Methadone and Buprenorphine During COVID-19 Emergency

June 10, 2020

Benjamin Oldfield

Benjamin Oldfield Editor-in-Chief of CATR. Clinical Instructor in Medicine and Pediatrics at Yale School of Medicine; Chief Medical Officer at Fair Haven Community Health Care, CT. Dr. Oldfield has disclosed that he has no relevant financial or other interests in any commercial companies pertaining to this educational activity.

In the context of a pandemic, how can and should our practices change to continue to meet the needs of patients with opioid use disorder? We summarize recent changes to the regulations surrounding medications for opioid use disorder: buprenorphine and methadone.