A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder
Abstract Buprenorphine has become an important medication in the context of the ongoing opioid epidemic. However, complex pharmacologic properties and varying government regulations create barriers to its use. This narrative review is intended to facilitate buprenorphine use—including non-traditiona...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Adis, Springer Healthcare
2023-11-01
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| Series: | Drugs in R&D |
| Online Access: | https://doi.org/10.1007/s40268-023-00443-5 |
| _version_ | 1797405783743266816 |
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| author | James C. Miller Michael A. Brooks Kelly E. Wurzel Emily J. Cox John F. Wurzel |
| author_facet | James C. Miller Michael A. Brooks Kelly E. Wurzel Emily J. Cox John F. Wurzel |
| author_sort | James C. Miller |
| collection | DOAJ |
| description | Abstract Buprenorphine has become an important medication in the context of the ongoing opioid epidemic. However, complex pharmacologic properties and varying government regulations create barriers to its use. This narrative review is intended to facilitate buprenorphine use—including non-traditional initiation methods—by providers ranging from primary care providers to addiction specialists. This article briefly discusses the opioid epidemic and the diagnosis and treatment of opioid use disorder (OUD). We then describe the basic and complex pharmacologic properties of buprenorphine, linking these properties to their clinical implications. We guide readers through the process of initiating buprenorphine in patients using full agonist opioids. As there is no single recommended approach for buprenorphine initiation, we discuss the details, advantages, and disadvantages of the standard, low-dose, bridging-strategy, and naloxone-facilitated initiation techniques. We consider the pharmacology of, and evidence base for, buprenorphine in the treatment of pain, in both OUD and non-OUD patients. Throughout, we address the use of buprenorphine in children and adolescent patients, and we finish with considerations related to the settings of pregnancy and breastfeeding. |
| first_indexed | 2024-03-09T03:16:08Z |
| format | Article |
| id | doaj.art-9d9736f4ea8644629a4abd463768a0bf |
| institution | Directory Open Access Journal |
| issn | 1174-5886 1179-6901 |
| language | English |
| last_indexed | 2024-03-09T03:16:08Z |
| publishDate | 2023-11-01 |
| publisher | Adis, Springer Healthcare |
| record_format | Article |
| series | Drugs in R&D |
| spelling | doaj.art-9d9736f4ea8644629a4abd463768a0bf2023-12-03T15:21:59ZengAdis, Springer HealthcareDrugs in R&D1174-58861179-69012023-11-0123433936210.1007/s40268-023-00443-5A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use DisorderJames C. Miller0Michael A. Brooks1Kelly E. Wurzel2Emily J. Cox3John F. Wurzel4Psychiatry Residency Spokane, Providence Sacred Heart Medical Center and Children’s HospitalPsychiatry Residency Spokane, Providence Sacred Heart Medical Center and Children’s HospitalPsychiatry Residency Spokane, Providence Sacred Heart Medical Center and Children’s HospitalProvidence Research NetworkPsychiatry Residency Spokane, Providence Sacred Heart Medical Center and Children’s HospitalAbstract Buprenorphine has become an important medication in the context of the ongoing opioid epidemic. However, complex pharmacologic properties and varying government regulations create barriers to its use. This narrative review is intended to facilitate buprenorphine use—including non-traditional initiation methods—by providers ranging from primary care providers to addiction specialists. This article briefly discusses the opioid epidemic and the diagnosis and treatment of opioid use disorder (OUD). We then describe the basic and complex pharmacologic properties of buprenorphine, linking these properties to their clinical implications. We guide readers through the process of initiating buprenorphine in patients using full agonist opioids. As there is no single recommended approach for buprenorphine initiation, we discuss the details, advantages, and disadvantages of the standard, low-dose, bridging-strategy, and naloxone-facilitated initiation techniques. We consider the pharmacology of, and evidence base for, buprenorphine in the treatment of pain, in both OUD and non-OUD patients. Throughout, we address the use of buprenorphine in children and adolescent patients, and we finish with considerations related to the settings of pregnancy and breastfeeding.https://doi.org/10.1007/s40268-023-00443-5 |
| spellingShingle | James C. Miller Michael A. Brooks Kelly E. Wurzel Emily J. Cox John F. Wurzel A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder Drugs in R&D |
| title | A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder |
| title_full | A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder |
| title_fullStr | A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder |
| title_full_unstemmed | A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder |
| title_short | A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder |
| title_sort | guide to expanding the use of buprenorphine beyond standard initiations for opioid use disorder |
| url | https://doi.org/10.1007/s40268-023-00443-5 |
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