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Buprenorphine and adherence

Preeti Barnwal, Saibal Das, Somnath Mondal, Anand Ramasamy, Tanay Maiti, Arunava Saha
Opioid dependence leads to physical dependence and addiction which finally results in profound medical, psychological and social dysfunction. One of the useful medications for opioid dependence is buprenorphine, the partial opioid agonist, which is used alone or in combination with naloxone. However, buprenorphine is the victim of its own success due to its illicit use and accidental poisoning in children. Also, buprenorphine typically requires daily self-administration and its effectiveness heavily depends on patient adherence...
March 2017: Therapeutic Advances in Psychopharmacology
Suzanne Nielsen, Briony Larance, Nicholas Lintzeris
Clinical Question: Are different opioid agonist treatments (eg, methadone vs buprenorphine) associated with differences in efficacy for treating prescription opioid dependence, and is long-term maintenance of opioid agonist treatment associated with differences in efficacy compared with opioid taper or psychological treatments alone? Bottom Line: For patients who are dependent on prescription opioids, long-term maintenance of opioid agonists is associated with less prescription opioid use and better adherence to medication and psychological therapies for opioid dependence compared with opioid taper or psychological treatments alone...
March 7, 2017: JAMA: the Journal of the American Medical Association
Jennifer L Brown, Nicole K Gause, Daniel Lewis, Theresa Winhusen
BACKGROUND: Hepatitis C Virus (HCV) risk is elevated for individuals with an opioid use disorder (OUD). Routine HCV testing is recommended for high-risk individuals, including those with an injection drug use history. HCV antibody testing addresses the first step in the HCV treatment care cascade, with uptake and completion of HCV treatment among individuals with chronic HCV as the optimal care cascade endpoint. The aim of this study was to characterize self-reported HCV treatment cascade outcomes among individuals with an OUD in outpatient medication assisted treatment (MAT)...
February 2, 2017: Journal of Substance Abuse Treatment
Maria Sullivan, Adam Bisaga, Martina Pavlicova, C Jean Choi, Kaitlyn Mishlen, Kenneth M Carpenter, Frances R Levin, Elias Dakwar, John J Mariani, Edward V Nunes
OBJECTIVE: At present there is no established optimal approach for transitioning opioid-dependent adults to extended-release injection naltrexone (XR-naltrexone) while preventing relapse. The authors conducted a trial examining the efficacy of two methods of outpatient opioid detoxification for induction to XR-naltrexone. METHOD: Participants were 150 opioid-dependent adults randomly assigned 2:1 to one of two outpatient detoxification regimens, naltrexone-assisted detoxification or buprenorphine-assisted detoxification, followed by an injection of XR-naltrexone...
January 10, 2017: American Journal of Psychiatry
David H Gustafson, Gina Landucci, Fiona McTavish, Rachel Kornfield, Roberta A Johnson, Marie-Louise Mares, Ryan P Westergaard, Andrew Quanbeck, Esra Alagoz, Klaren Pe-Romashko, Chantelle Thomas, Dhavan Shah
BACKGROUND: Opioid dependence has devastating and increasingly widespread consequences and costs, and the most common outcome of treatment is early relapse. People who inject opioids are also at disproportionate risk for contracting the human immunodeficiency virus (HIV) and hepatitis C virus (HCV). This study tests an approach that has been shown to improve recovery rates: medication along with other supportive services (medication-assisted treatment, or MAT) against MAT combined with a smartphone innovation called A-CHESS (MAT + A-CHESS)...
December 12, 2016: Trials
Nihit Kumar, Zachary N Stowe, Xiaotong Han, Michael J Mancino
BACKGROUND: Early adverse life events such as childhood trauma have been linked to development of substance use disorders. The prevalence and impact on treatment of early childhood trauma in opioid-dependent individuals has received limited research attention. The present study examined reported childhood trauma and its relation to retention and adherence in an outpatient buprenorphine treatment program. METHODS: Medical records of individuals who completed childhood trauma questionnaire (CTQ) were reviewed to extract baseline data and demographics (N = 113)...
October 2016: American Journal on Addictions
David E Marcovitz, R Kathryn McHugh, Julie Volpe, Victoria Votaw, Hilary S Connery
BACKGROUND AND OBJECTIVES: Identifying predictors of early drop out from outpatient treatment of opioid use disorder (OUD) with buprenorphine/naloxone (BN) may improve care for subgroups requiring more intensive engagement to achieve stabilization. However, previous research on predictors of dropout among this population has yielded mixed results. The aim of the present study was to elucidate these mixed findings by simultaneously evaluating a range of putative risk factors that may predict dropout in BN maintenance treatment...
September 2016: American Journal on Addictions
Richard N Rosenthal, Michelle R Lofwall, Sonnie Kim, Michael Chen, Katherine L Beebe, Frank J Vocci
IMPORTANCE: The effectiveness of buprenorphine treatment of opioid dependence is limited by suboptimal medication adherence, abuse, and diversion. OBJECTIVE: To determine whether 6-month buprenorphine implants are noninferior to daily sublingual buprenorphine as maintenance treatment for opioid-dependent patients with stable abstinence. DESIGN, SETTING, AND PARTICIPANTS: Outpatient, randomized, active-controlled, 24-week, double-blind, double-dummy study conducted at 21 US sites from June 26, 2014, through May 18, 2015...
July 19, 2016: JAMA: the Journal of the American Medical Association
Wilson M Compton, Nora D Volkow
No abstract text is available yet for this article.
July 19, 2016: JAMA: the Journal of the American Medical Association
Philip G Conaghan, Michael Serpell, Paula McSkimming, Rod Junor, Sara Dickerson
BACKGROUND: Osteoarthritis (OA) causes substantial pain and reduced health-related quality of life (HRQL). Although opioid analgesics are commonly used, the relative benefits of different opioids are poorly studied. Transdermal buprenorphine (TDB) offers an alternative to oral opioids for the treatment of moderate-to-severe chronic pain. This observational study of people with OA pain assessed satisfaction, HRQL and medication adherence. METHODS: Patients in the UK with self-reported knee and/or hip OA who had been receiving one or more of TDB, co-codamol (an oral paracetamol/codeine combination) and tramadol for at least 1 month completed an online or telephone questionnaire...
2016: Patient
Nikolaj Kunøe, Arild Opheim, Kristin Klemmetsby Solli, Zhanna Gaulen, Kamni Sharma-Haase, Zill-E-Huma Latif, Lars Tanum
BACKGROUND: Current guidelines for opioid dependence recommend daily maintenance of physical dependence with methadone or buprenorphine, and discourage abstinence due to the high risk of relapse and overdose. Extended-release formulations of the opioid antagonist naltrexone (XR-NTX) block heroin and other opioid agonists competitively for around 4 weeks per administration. XR-NTX thus enables opioid users to experience abstinence from opioid agonists with greatly reduced risk of overdose compared to medication-free abstinence...
April 28, 2016: BMC Pharmacology & Toxicology
Essiina Launonen, Isla Wallace, Elina Kotovirta, Hannu Alho, Kaarlo Simojoki
BACKGROUND: The intravenous (IV) use of opioid maintenance treatment (OMT) medications and other intoxicating drugs among OMT patients is a challenge for many OMT units and affects treatment outcomes. The aim of this study is to examine factors associated with IV use of OMT medications and other intoxicating drugs among Finnish OMT patients. METHODS: A cross-sectional study was conducted among all Finnish OMT patients of whom 60% (n=1508) participated. The data were collected by anonymous questionnaire...
May 1, 2016: Drug and Alcohol Dependence
Walter Ling, Maureen P Hillhouse, Andrew J Saxon, Larissa J Mooney, Christie M Thomas, Alfonso Ang, Abigail G Matthews, Albert Hasson, Jeffrey Annon, Steve Sparenborg, David S Liu, Jennifer McCormack, Sarah Church, William Swafford, Karen Drexler, Carolyn Schuman, Stephen Ross, Katharina Wiest, P Todd Korthuis, William Lawson, Gregory S Brigham, Patricia C Knox, Michael Dawes, John Rotrosen
AIMS: To examine the safety and effectiveness of buprenorphine + naloxone sublingual tablets (BUP, as Suboxone(®) ) provided after administration of extended-release injectable naltrexone (XR-NTX, as Vivitrol(®) ) to reduce cocaine use in participants who met DSM-IV criteria for cocaine dependence and past or current opioid dependence or abuse. METHODS: This multi-centered, double-blind, placebo-controlled study, conducted under the auspices of the National Drug Abuse Treatment Clinical Trials Network, randomly assigned 302 participants at sites in California, Oregon, Washington, Colorado, Texas, Georgia, Ohio, New York and Washington DC, USA to one of three conditions provided with XR-NTX: 4 mg/day BUP (BUP4, n = 100), 16 mg/day BUP (BUP16, n = 100, or no buprenorphine (placebo; PLB, n = 102)...
August 2016: Addiction
Bobbi Jo H Yarborough, Scott P Stumbo, Dennis McCarty, Jennifer Mertens, Constance Weisner, Carla A Green
BACKGROUND: Patients and clinicians have begun to recognize the advantages and disadvantages of buprenorphine relative to methadone, but factors that influence choices between these two medications remain unclear. For example, we know little about how patients' preferences and previous experiences influence treatment decisions. Understanding these issues may enhance treatment engagement and retention. METHODS: Adults with opioid dependence (n=283) were recruited from two integrated health systems to participate in interviews focused on prior experiences with treatment for opioid dependence, knowledge of medication options, preferences for treatment, and experiences with treatment for chronic pain in the context of problems with opioids...
March 1, 2016: Drug and Alcohol Dependence
Suneeta Kumari, Partam Manalai, Sharlene Leong, Alese Wooditch, Mansoor Malik, William B Lawson
BACKGROUND AND OBJECTIVES: Opioid use disorders are common, chronic relapsing disorders. Buprenorphine (BUP) is an FDA approved medication in the treatment of opioid use disorders, but patient adherence to this medication remains a challenge. To identify risk factors for non-adherence, this chart review study examined the association between DSM-IV Axis I psychiatric disorders, substance use, demographics, and adherence to BUP-naloxone in African-American patients. METHODS: Charts were selected of patients who had ≥5 visits and completed psychometric screens (Patient Health Questionnaire, Mood Disorder Questionnaire, and a posttraumatic stress disorder questionnaire) at the time of the initial visit (N = 50)...
March 2016: American Journal on Addictions
Babak Tofighi, Ellie Grossman, Sewit Bereket, Joshua D Lee
Few studies have evaluated text message content preferences to support evidence-based treatment approaches for opioid use disorders, and none in primary care office-based buprenorphine treatment settings. This study assessed the acceptability and preferences for a tailored text message intervention in support of core office-based buprenorphine treatment medical management components (e.g., treatment adherence, encouraging abstinence, 12-step group participation, motivational interviewing, and patient-provider communication as needed)...
2016: Journal of Addictive Diseases
Mrunal Bandawar, Arun Kandasamy, Prabhat Chand, Pratima Murthy, Vivek Benegal
BACKGROUND: Opioid Use disorders are emerging as a serious public health concern in India. Opioid substitution treatment is one of the emerging forms of treatment in this population which needs more evidence to increase its availability and address prejudices towards the same. MATERIALS AND METHODS: This is a case control study with retrospective design reviewing the charts of patients with opioid dependence syndrome registered between January 2005 to December 2012...
July 2015: Indian Journal of Psychological Medicine
Mick Serpell, Shiva Tripathi, Sabine Scherzinger, Sònia Rojas-Farreras, Alexander Oksche, Margaret Wilson
BACKGROUND: Opioids provide effective analgesia for moderate-to-severe, chronic pain. Transdermal buprenorphine (TDB) is available in the UK as weekly, lower-dose (5-20 μg/h) patches and twice-weekly, higher dose (35-70 μg/h) patches. This prospective, observational, multicenter study of patients with various chronic pain conditions assessed the safety, perceptions, and discontinuation of treatment with TDB in a real-world, non-interventional setting ( study ID: NCT01225861)...
February 2016: Patient
Anne Bergenstrom, Baseer Achakzai, Sofia Furqan, Manzoor ul Haq, Rajwal Khan, Marc Saba
Pakistan is among four countries in Asia where the estimated number of new HIV infections has been increasing year by year ever since 1990. The Asian Epidemic Modelling (AEM), conducted in 2015, reconfirmed that the use of contaminated injection equipment among people who inject drugs (PWID) remains the main mode of HIV transmission in the country. The estimated number of PWID ranges from 104,804 to 420,000 PWID. HIV prevalence in this population is above 40 % in several cities, including Faisalabad (52.5 %), D...
2015: Harm Reduction Journal
Briony Larance, Richard Mattick, Robert Ali, Nicholas Lintzeris, Rebecca Jenkinson, Nancy White, Ivana Kihas, Rosemary Cassidy, Louisa Degenhardt
INTRODUCTION AND AIMS: We report 2 years of post-marketing surveillance of the diversion and injection of buprenorphine-naloxone (BNX) film following its introduction in 2011. DESIGN AND METHODS: Interviews were conducted with people who inject drugs regularly (PWID) (2004-2013), opioid substitution therapy clients (2013, n = 492) and key experts (n = 44). Key outcomes were unsanctioned removal of supervised doses, diversion, injection and street price. Prevalence of past 6-month injection among PWID was adjusted for background availability of opioid substitution therapy medications using sales data...
October 9, 2015: Drug and Alcohol Review
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