buprenorphine | CARLAT PUBLISHING

EXPERT Q&A

Buprenorphine and Dental Issues

January 30, 2023

Talia Puzantian, PharmD, BCPP.

Deputy editor for The Carlat Addiction Treatment Report. Professor, Keck Graduate Institute School of Pharmacy. Claremont, CA.

Dr. Puzantian has no financial relationships with companies related to this material.

Buprenorphine is a first line treatment for opioid use disorder and has saved countless lives, but new warnings about associations between certain buprenorphine formulations and dental problems have people worried. Here, Dr. Puzantian reviews the data and shows us how to apply this new information to clinical care.

CLINICAL UPDATE

What to Know About Injectable Buprenorphine (Sublocade)

January 30, 2023

Audrey Abelleira, PharmD, BCPP

Audrey Abelleira, PharmD, BCPP. Clinical pharmacist practitioner, Pain Management and Opioid Safety Program Coordinator, VA Connecticut Healthcare System. Clinical instructor, Yale School of Medicine. New Haven, CT.

Dr. Abelleira has no financial relationships with companies related to this material.

Various formulations of buprenorphine abound, and a new long-acting injectable form (Sublocade) is one of the latest arrivals. But does it actually work? Here, we review the pharmacology behind it, go over efficacy data, and provide guidance on how to decide when to consider long-acting injectable buprenorphine for your patients.

RESEARCH UPDATE

Sublocade vs SL Buprenorphine after Release from Jail

September 1, 2022

Peter J. Farago, MD.

Peter J. Farago, MD. Dr. Farago, author of this educational activity, has no relevant financial relationship(s) with ineligible companies to disclose.

The period immediately following release from incarceration is associated with an elevated risk of overdose among those with opioid use disorder. In this randomized trial, researchers were able to show that long-acting injectable buprenorphine (Sublocade) is a feasible and effective treatment for this high-risk population.

Add-On Buprenorphine for Methamphetamine Use Disorder

March 1, 2022

Sanya Virani, MD.

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

There are very few medication options shown to be effective for the treatment of methamphetamine use disorder. Here, researchers examine the utility of buprenorphine to reduce drug cravings.

Buprenorphine Treatment

November 5, 2021

Noah Capurso, MD

Noah Capurso, MD

Assistant Professor of Psychiatry at Yale University, CT. Editor-in-chief of The Carlat Addiction Treatment Report.

Dr. Capurso has disclosed no relevant financial or other interests in any commercial companies pertaining to this educational activity.

Buprenorphine is a first line medication for the treatment of opioid use disorder yet remains vastly under-prescribed. Here, Dr. Capurso reviews the pharmacologic principles relevant to buprenorphine prescribing and lays out how to start patients on the medication both in the clinic and at home.

A New Buprenorphine Dosing Strategy for Easier Induction From Fentanyl

November 5, 2021

Oluwole Jegede, MD, PhD

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

Avoiding buprenorphine induced withdrawal during induction can be particularly tricky for those using fentanyl. Researchers describe a novel induction dosing strategy that mitigates this risk.

Buprenorphine Induction Without Withdrawal

November 5, 2021

David Moltz, MD.

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

Making the switch from full opioid agonist to buprenorphine usually involves a period of withdrawal prior to starting the medication. Here, researchers describe a method of switching from full to partial opioid agonist by using small “microdoses” in order to avoid withdrawal.

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

November 5, 2021

Gregory Lande, MD.

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.