1
|
A Narrative Review of Pharmacotherapy Treatment for Opioid Addiction and Application in a Community-Based Model in Victoria, Australia. Int J Ment Health Addict 2020. [DOI: 10.1007/s11469-018-9936-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
|
2
|
Ghosh A, Basu D, Avasthi A. Buprenorphine-based opioid substitution therapy in India: A few observations, thoughts, and opinions. Indian J Psychiatry 2018; 60:361-366. [PMID: 30405267 PMCID: PMC6201663 DOI: 10.4103/psychiatry.indianjpsychiatry_218_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The most evidence-based treatment for opioid dependence is opioid agonist maintenance treatment also known as opioid substitution therapy (OST). However, there are some critical, yet unaddressed issues of buprenorphine-based substitution therapy, especially in the Indian context. These comprise of generalizability of the evidence for OST, especially for natural and pharmaceutical opioids and for all age groups, optimum dose and duration of OST, and mode of treatment delivery including the frequency of dispensing. Notwithstanding the use of buprenorphine-naloxone combination, abuse and diversion are serious but often underreported problems. There is an urgent need for health services research in India on OST, focusing on these aspects. Rather than directly copying from Western models, it is important to try to understand the useful and safe program and policy options likely to be applicable in the Indian setting, with our own assets as well as vulnerabilities.
Collapse
Affiliation(s)
- Abhishek Ghosh
- Department of Psychiatry, Drug De-Addiction and Treatment Centre, PGIMER, Chandigarh, India
| | - Debasish Basu
- Department of Psychiatry, Drug De-Addiction and Treatment Centre, PGIMER, Chandigarh, India
| | - Ajit Avasthi
- Department of Psychiatry, PGIMER, Chandigarh, India
| |
Collapse
|
3
|
Prescription opioid abuse in prison settings: A systematic review of prevalence, practice and treatment responses. Drug Alcohol Depend 2017; 171:122-131. [PMID: 28086177 DOI: 10.1016/j.drugalcdep.2016.11.032] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 11/08/2016] [Accepted: 11/10/2016] [Indexed: 11/20/2022]
Abstract
BACKGROUND To systematically review the quantitative and qualitative evidence base pertaining to the prevalence, practice of, and treatment response to the diversion of prescribed opiates in the prison setting. METHODS Medline, Embase, CINAHL, PsycINFO, Google Scholar, ASSIA and Science Direct databases were searched for papers from 1995 to the present relevant to the abuse of prescribed opiate medication. Identified journals and their reference lists were hand searched for other relevant articles. Of the abstracts identified as relevant, full text papers were retrieved and critiqued against the inclusion criteria for the review. RESULTS Three hundred and fifty-five abstracts were identified, leading to 42 full-text articles being retrieved. Of those, 10 papers were included in the review. Significant differences in abuse behaviours between different countries were reported. However, a key theme emerged from the data regarding a culture of nasal administration of prescribed sublingual buprenorphine within some prisons due to both reduced prevalence of injection within prison and reduced supplies of illicit drugs within prison. The buprenorphine/naloxone preparation appears to be less amenable to abuse. The review highlighted a paucity of empirical research pertaining to both prevalence of the phenomenon and treatment responses. CLINICAL AND RESEARCH IMPLICATIONS Healthcare providers within prisons need to prescribe opioids in the least abuseable preparation since the risk of abuse is significant, despite widespread processes of supervised dispensing. Prescription medication abuse is not limited to opioids and the predominant drug of abuse in an individual prison can rapidly change according to availability.
Collapse
|
4
|
Diminution de la prévalence du docteur shopping de la buprénorphine entre 2004 et 2014 en France. Presse Med 2016; 45:e369-e375. [DOI: 10.1016/j.lpm.2016.10.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Accepted: 07/27/2016] [Indexed: 11/19/2022] Open
|
5
|
Launonen E, Wallace I, Kotovirta E, Alho H, Simojoki K. Factors associated with non-adherence and misuse of opioid maintenance treatment medications and intoxicating drugs among Finnish maintenance treatment patients. Drug Alcohol Depend 2016; 162:227-35. [PMID: 27068849 DOI: 10.1016/j.drugalcdep.2016.03.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2015] [Revised: 03/19/2016] [Accepted: 03/21/2016] [Indexed: 11/28/2022]
Abstract
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. Binominal regression analysis with unadjusted and adjusted ORs was conducted to evaluate predictors for IV use. FINDINGS Factors associated with the injection of a patient's own OMT medication were: being treated with buprenorphine-naloxone (BNX) (OR 2.60, p=0.005) with a low dose (<9.0mg/day; OR 5.70, p<0.001) and being treated in a health-care centre (OR 2.03, p=0.029). Factors associated with the injection of illicit OMT medications were: being treated with BNX (OR 5.25, p<0.001) with a low dose (<9.0mg/day; OR 2.89, p=0.017), lack of psychosocial support (OR 2.62, p<0.001) and concurrent use of psychotropic medications from illicit sources (OR 4.28, p<0.001). Associated factors for the injection of other intoxicating drugs were: concurrent use of illicit drugs (OR 1.72, p=0.015), psychotropic medications from illicit sources (OR 4.78, p<0.001) and from a doctor (OR 1.93, p=0.004). CONCLUSIONS More effort should be made to reduce concurrent injecting use during OMT. This may be done by addressing concurrent substance use orders more effectively, by ensuring that patients receive an optimal BNX dose and by providing more psychosocial support.
Collapse
Affiliation(s)
- Essiina Launonen
- Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; University of Eastern Finland, School of Medicine, Faculty of Health Sciences, P.O. Box 1627, FI-70211 Kuopio, Finland.
| | - Isla Wallace
- Department of Applied Health Research, University College London, Torrington Place, London WC1E 7HB, UK
| | - Elina Kotovirta
- Ministry of Social Affairs and Health, Department for Promotion of Welfare and Health, Unit for Harm Prevention, P.O. Box 33, FI-00023 Government, Finland
| | - Hannu Alho
- Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; National Institute of Health and Welfare, Department of Mental and Substance Abuse Services, P.O. Box 30, FI-00271 Helsinki, Finland
| | - Kaarlo Simojoki
- Clinicum, University of Helsinki and Helsinki University Hospital, P.O. Box 63, FI-00014 Helsinki University, Finland; A-Clinic Foundation, Maistraatinportti 2, 00240 Helsinki, Finland
| |
Collapse
|
6
|
Walsh SL, Nuzzo PA, Babalonis S, Casselton V, Lofwall MR. Intranasal buprenorphine alone and in combination with naloxone: Abuse liability and reinforcing efficacy in physically dependent opioid abusers. Drug Alcohol Depend 2016; 162:190-8. [PMID: 27012435 PMCID: PMC4833536 DOI: 10.1016/j.drugalcdep.2016.03.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 03/07/2016] [Accepted: 03/09/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND Buprenorphine can be abused by the intranasal route. This study sought to examine the relative abuse liability and reinforcing efficacy of intranasal buprenorphine compared to intranasal buprenorphine/naloxone in opioid-dependent individuals. METHODS Eleven healthy male and female volunteers physically dependent on short-acting opioids resided as inpatients during participation in this double blind, within subject, placebo-controlled study. Participants were maintained on oxycodone (30 mg/q.i.d., p.o.) throughout the 6-week study. Eight pairs of experimental sessions were conducted at ≥48 h intervals to examine the pharmacodynamic profile (Sample) and reinforcing efficacy (Self-administration the following day) of intranasal placebo, oxycodone (60 mg), buprenorphine (2, 8 & 16 mg) and buprenorphine/naloxone (2/0.5, 8/2 & 16/4 mg). Subjective, observer-rated and physiological measures were collected to assess the magnitude of opioid agonist and antagonist effects. A progressive ratio self-administration procedure assessed choices for drug versus money. RESULTS All active doses produced opioid agonist-like effects (e.g., increased ratings of "liking," and miosis) compared to placebo. The effects of buprenorphine and buprenorphine/naloxone were not reliably dose-dependent. Intranasal buprenorphine/naloxone elicited modest and transient opioid withdrawal-like effects in the first hour post-drug administration, while simultaneously blunting or blocking the early onset of agonist effects seen with buprenorphine alone. All active doses of buprenorphine were self-administered more than placebo, but buprenorphine/naloxone doses were not. CONCLUSIONS These data confirm that intranasal buprenorphine/naloxone has deterrent properties related to transient withdrawal effects that likely decrease its desirability for misuse compared to buprenorphine in opioid-dependent individuals maintained on short-acting opioids.
Collapse
Affiliation(s)
- Sharon L Walsh
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA; Department of Behavioral Science, University of Kentucky, USA; Department of Psychiatry, University of Kentucky, USA; Department of Pharmacology, University of Kentucky, USA; Department of Pharmaceutical Sciences, University of Kentucky, USA.
| | - Paul A Nuzzo
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA; Department of Behavioral Science, University of Kentucky, USA.
| | - Shanna Babalonis
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA; Department of Behavioral Science, University of Kentucky, USA.
| | - Victoria Casselton
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA.
| | - Michelle R Lofwall
- Center on Drug and Alcohol Research, University of Kentucky, 845 Angliana Avenue, Lexington, KY 40508, USA; Department of Behavioral Science, University of Kentucky, USA; Department of Psychiatry, University of Kentucky, USA.
| |
Collapse
|
7
|
Delorme J, Chenaf C, Kabore JL, Pereira B, Mulliez A, Tremey A, Brousse G, Zenut M, Laporte C, Authier N. Incidence of high dosage buprenorphine and methadone shopping behavior in a retrospective cohort of opioid-maintained patients in France. Drug Alcohol Depend 2016; 162:99-106. [PMID: 27006272 DOI: 10.1016/j.drugalcdep.2016.02.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/09/2016] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Opioid Substitution Treatment (OST) misuse and diversion have significantly increased worldwide. Obtaining OST prescriptions from multiple prescribers, known as doctor shopping, is a way in which opioids may be diverted. OBJECTIVES The aim of this study was to assess the incidence of OST (high dosage buprenorphine (HDB) and methadone (MTD)) shopping behavior and identify associated risk factors, and its impact on mortality. METHODS A retrospective cohort of patients treated by OST between April 1, 2004 and December 31, 2012 from a sample of the French Health Insurance database was established. Doctor shopping was defined as ≥1 day of overlapping prescriptions written by ≥2 different prescribers and filled in ≥3 different pharmacies. RESULTS A total of 2043 patients were enrolled, 1450HDB and 593 MTD. The one-year incidence of shopping behavior was 8.4% (95% CI: 7.0-10.1) in HDB group and 0% in MTD group, compared to 0.2% (95% CI: 0.1-0.2) for diuretics. On multivariate analysis, factors associated with HDB shopping behavior were: male gender HR: 1.74 (95% CI: 1.20-2.54); low-income status HR: 2.95 (95% CI: 2.07-4.44); mental health disorders HR: 1.43 (95% CI: 1.06-1.94); concurrent hypnotics use HR: 1.90 (95% CI: 1.39-2.61); concurrent use of weak opioids HR: 1.48 (95% CI: 1.09-1.99) and morphine HR: 1.69 (95% CI: 1.02-2.80). HDB shoppers had a higher, yet non-significant risk of death (HR: 1.56 (95% CI: 0.64-3.81)) than non HDB shoppers. CONCLUSION Shopping behavior was only found in high dosage buprenorphine patients and concerned almost one out ten patients.
Collapse
Affiliation(s)
- Jessica Delorme
- INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, BP38, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France.
| | - Chouki Chenaf
- INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, BP38, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France
| | - Jean-Luc Kabore
- INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, BP38, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France
| | - Bruno Pereira
- CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, BP69, 63003 Clermont-Ferrand, France
| | - Aurélien Mulliez
- CHU Clermont-Ferrand, Délégation à la Recherche Clinique et à l'Innovation, BP69, 63003 Clermont-Ferrand, France
| | - Aurore Tremey
- CHU Clermont-Ferrand, Service de Psychiatrie et Addictologie, CMPB, BP69, 63003 Clermont-Ferrand, France
| | - Georges Brousse
- CHU Clermont-Ferrand, Service de Psychiatrie et Addictologie, CMPB, BP69, 63003 Clermont-Ferrand, France
| | - Marie Zenut
- CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France; EA 4681 PEPRADE, Université d'Auvergne (Périnatalité, grossesse, Environnement, PRAtiques médicales et DEveloppement), France
| | - Catherine Laporte
- Département de Médecine Générale, Faculté de Médecine, BP38, 63001 Clermont- Ferrand, France
| | - Nicolas Authier
- INSERM, UMR 1107 NEURO-DOL, Faculté de Médecine, Université d'Auvergne, BP38, 63001 Clermont-Ferrand, France; CHU Clermont-Ferrand, Centres Addictovigilance et Pharmacovigilance Auvergne (CEIP-CRPV), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France; CHU Clermont-Ferrand, Centre d'Evaluation et de Traitement de la Douleur (CETD), Service de Pharmacologie Médicale, BP69, 63003 Clermont-Ferrand, France; Institut Analgesia, Faculté de Médecine, BP38, 63001 Clermont-Ferrand, France
| |
Collapse
|
8
|
Gasior M, Bond M, Malamut R. Routes of abuse of prescription opioid analgesics: a review and assessment of the potential impact of abuse-deterrent formulations. Postgrad Med 2015; 128:85-96. [DOI: 10.1080/00325481.2016.1120642] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
|
9
|
Mohammed Z, Hughes GJ, Hearty P, Wright NMJ. The perceived and actual consequences of intranasal administration of buprenorphine or burprenorphine–naloxone by prisoners. DRUGS-EDUCATION PREVENTION AND POLICY 2015. [DOI: 10.3109/09687637.2015.1085491] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Zanib Mohammed
- Department of Health Sciences, University of York, Heslington, York, UK,
| | - Gareth J. Hughes
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK,
| | | | | |
Collapse
|
10
|
Diversion of opioid maintenance treatment medications and predictors for diversion among Finnish maintenance treatment patients. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2015; 26:875-82. [DOI: 10.1016/j.drugpo.2015.03.007] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2015] [Revised: 03/20/2015] [Accepted: 03/22/2015] [Indexed: 11/22/2022]
|
11
|
Jones JD, Sullivan MA, Vosburg SK, Manubay JM, Mogali S, Metz V, Comer SD. Abuse potential of intranasal buprenorphine versus buprenorphine/naloxone in buprenorphine-maintained heroin users. Addict Biol 2015; 20:784-98. [PMID: 25060839 DOI: 10.1111/adb.12163] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In spite of the clinical utility of buprenorphine, parenteral abuse of this medication has been reported in several laboratory investigations and in the real world. Studies have demonstrated lower abuse liability of the buprenorphine/naloxone combination relative to buprenorphine alone. However, clinical research has not yet examined the utility of the combined formulation to deter intranasal use in a buprenorphine-maintained population. Heroin-using volunteers (n = 12) lived in the hospital for 8-9 weeks and were maintained on each of three sublingual buprenorphine doses (2, 8, 24 mg). Under each maintenance dose, participants completed laboratory sessions during which the reinforcing and subjective effects of intranasal doses of buprenorphine (8, 16 mg), buprenorphine/naloxone (8/2, 8/8, 8/16, 16/4 mg) and controls (placebo, heroin 100 mg, naloxone 4 mg) were assessed. Intranasal buprenorphine alone typically produced increases in positive subjective effects and the 8 mg dose was self-administered above the level of placebo. The addition of naloxone dose dependently reduced positive subjective effects and increased aversive effects. No buprenorphine/naloxone combination dose was self-administered significantly more than placebo. These data suggest that within a buprenorphine-dependent population, intranasal buprenorphine/naloxone has reduced abuse potential in comparison to buprenorphine alone. These data strongly argue in favor of buprenorphine/naloxone rather than buprenorphine alone as the more reasonable option for managing the risk of buprenorphine misuse.
Collapse
Affiliation(s)
- Jermaine D. Jones
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Maria A. Sullivan
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Suzanne K. Vosburg
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Jeanne M. Manubay
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Shanthi Mogali
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Verena Metz
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| | - Sandra D. Comer
- Division of Substance Abuse; New York Psychiatric Institute and Department of Psychiatry; College of Physicians and Surgeons of Columbia University; New York NY USA
| |
Collapse
|
12
|
Jones JD, Madera G, Comer SD. The reinforcing and subjective effects of intravenous and intranasal buprenorphine in heroin users. Pharmacol Biochem Behav 2014; 122:299-306. [PMID: 24793093 DOI: 10.1016/j.pbb.2014.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 04/21/2014] [Accepted: 04/24/2014] [Indexed: 11/24/2022]
Abstract
Abuse of buprenorphine (BUP) by the intravenous (IV) route has been documented in several studies, and reports of intranasal (IN) abuse are increasing. However, no studies have directly compared the effects of BUP when it is administered intranasally and intravenously. The present secondary analysis used data from two separate studies to compare the reinforcing and subjective effects of IV and IN buprenorphine. One study evaluated IV buprenorphine (N=13) and the other evaluated IN buprenorphine (N=12). Participants were maintained on 2 mg sublingual (SL) BUP and tested with each intranasal or intravenous buprenorphine test dose (0 mg, 2 mg, 4 mg, 8 mg, and 16 mg). During morning laboratory sessions, participants received money (US $20) and sample doses of IN or IV BUP, and then completed subjective effects questionnaires. Later that day, they completed a self-administration task to receive 10% portions of the drug and/or money they previously sampled. In general, positive subjective ratings for both IV and IN BUP were significantly greater than placebo, with IV BUP having a greater effect than IN BUP. All active BUP doses (IV and IN) maintained significantly higher progressive ratio breakpoint values than placebo, but breakpoint values for IV BUP were greater than for IN BUP. Buprenorphine is an effective maintenance treatment for opioid dependence, valued for its ability to reduce the positive subjective effects of other opioids. Nevertheless, the present data demonstrate that in participants maintained on a low dose of SL BUP, the medication itself has abuse liability when used intravenously or intranasally.
Collapse
Affiliation(s)
- Jermaine D Jones
- Division on Substance Abuse, New York Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA.
| | - Gabriela Madera
- Division on Substance Abuse, New York Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA
| | - Sandra D Comer
- Division on Substance Abuse, New York Psychiatric Institute and Department of Psychiatry, College of Physicians and Surgeons of Columbia University, 1051 Riverside Drive, Unit 120, New York, NY 10032, USA
| |
Collapse
|
13
|
Graham RL. Buprenorphine for opioid dependence: Are there really differences between the formulations? Ment Health Clin 2014. [DOI: 10.9740/mhc.n186952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Buprenorphine and buprenorphine/naloxone sublingual tablets were approved by the FDA in 2002. In 2010, the buprenorphine/naloxone sublingual film was approved to address concerns of diversion, time for tablet dissolution, and unintentional exposure in children with the tablet. This article will compare the buprenorphine sublingual formulations in terms of pharmacokinetics, safety, diversion and misuse, cost, and patient preference. It will explore current data suggesting advantages or disadvantages of the various formulations since conclusive data are minimally available.
Collapse
Affiliation(s)
- Rebecca L. Graham
- Psychiatric Clinical Pharmacy Specialist, West Palm Beach VAMC, West Palm Beach, FL
| |
Collapse
|
14
|
Hill E, Han D, Dumouchel P, Dehak N, Quatieri T, Moehs C, Oscar-Berman M, Giordano J, Simpatico T, Blum K. Long term Suboxone™ emotional reactivity as measured by automatic detection in speech. PLoS One 2013; 8:e69043. [PMID: 23874860 PMCID: PMC3706486 DOI: 10.1371/journal.pone.0069043] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2013] [Accepted: 05/19/2013] [Indexed: 11/19/2022] Open
Abstract
Addictions to illicit drugs are among the nation's most critical public health and societal problems. The current opioid prescription epidemic and the need for buprenorphine/naloxone (Suboxone®; SUBX) as an opioid maintenance substance, and its growing street diversion provided impetus to determine affective states ("true ground emotionality") in long-term SUBX patients. Toward the goal of effective monitoring, we utilized emotion-detection in speech as a measure of "true" emotionality in 36 SUBX patients compared to 44 individuals from the general population (GP) and 33 members of Alcoholics Anonymous (AA). Other less objective studies have investigated emotional reactivity of heroin, methadone and opioid abstinent patients. These studies indicate that current opioid users have abnormal emotional experience, characterized by heightened response to unpleasant stimuli and blunted response to pleasant stimuli. However, this is the first study to our knowledge to evaluate "true ground" emotionality in long-term buprenorphine/naloxone combination (Suboxone™). We found in long-term SUBX patients a significantly flat affect (p<0.01), and they had less self-awareness of being happy, sad, and anxious compared to both the GP and AA groups. We caution definitive interpretation of these seemingly important results until we compare the emotional reactivity of an opioid abstinent control using automatic detection in speech. These findings encourage continued research strategies in SUBX patients to target the specific brain regions responsible for relapse prevention of opioid addiction.
Collapse
Affiliation(s)
- Edward Hill
- Department of Software and Information Technology Engineering, École de Technologie Supérieure - Université du Québec, Montréal, Québec, Canada
| | - David Han
- Department of Management Science and Statistics, University of Texas at San Antonio, San Antonio, Texas, United States of America
| | - Pierre Dumouchel
- Department of Software and Information Technology Engineering, École de Technologie Supérieure - Université du Québec, Montréal, Québec, Canada
| | - Najim Dehak
- Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, Massachusetts, United States of America
| | - Thomas Quatieri
- Lincoln Laboratory, Massachusetts Institute of Technology, Lexington, Massachusetts, United States of America
| | - Charles Moehs
- Occupational Medicine Associates, Watertown, New York, United States of America
| | - Marlene Oscar-Berman
- Departments of Psychiatry, Neurology, and Anatomy and Neurobiology, Boston University School of Medicine, and Boston Veteran Affaires Healthcare System, Boston, Massachusetts, United States of America
| | - John Giordano
- G & G Holistic Health Care Services, LLC., North Miami Beach, Florida, United States of America
| | - Thomas Simpatico
- Global Integrated Services Unit University of Vermont Center for Clinical and Translational Science, College of Medicine, Burlington, Vermont, United States of America
| | - Kenneth Blum
- G & G Holistic Health Care Services, LLC., North Miami Beach, Florida, United States of America
- Global Integrated Services Unit University of Vermont Center for Clinical and Translational Science, College of Medicine, Burlington, Vermont, United States of America
- Department of Psychiatry and McKnight Brain Institute, University of Florida, College of Medicine, Gainesville, Florida, United States of America
- Dominion Diagnostics, LLC, North Kingstown, Rhode Island, United States of America
- Department of Clinical Neurology, Path Foundation New York, New York, United States of America
- Department of Addiction Research and Therapy, Malibu Beach Recovery Center, Malibu Beach, California, United States of America
- Institute of Integrative Omics and Applied Biotechnology, Nonakuri, Purba Medinipur, West Bengal, India
| |
Collapse
|
15
|
Reducing abuse of orally administered prescription opioids using formulation technologies. J Drug Deliv Sci Technol 2013. [DOI: 10.1016/s1773-2247(13)50017-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
16
|
Abstract
This paper is the thirty-fourth consecutive installment of the annual review of research concerning the endogenous opioid system. It summarizes papers published during 2011 that studied the behavioral effects of molecular, pharmacological and genetic manipulation of opioid peptides, opioid receptors, opioid agonists and opioid antagonists. The particular topics that continue to be covered include the molecular-biochemical effects and neurochemical localization studies of endogenous opioids and their receptors related to behavior (Section 2), and the roles of these opioid peptides and receptors in pain and analgesia (Section 3); stress and social status (Section 4); tolerance and dependence (Section 5); learning and memory (Section 6); eating and drinking (Section 7); alcohol and drugs of abuse (Section 8); sexual activity and hormones, pregnancy, development and endocrinology (Section 9); mental illness and mood (Section 10); seizures and neurologic disorders (Section 11); electrical-related activity and neurophysiology (Section 12); general activity and locomotion (Section 13); gastrointestinal, renal and hepatic functions (Section 14); cardiovascular responses (Section 15); respiration (Section 16); and immunological responses (Section 17).
Collapse
Affiliation(s)
- Richard J Bodnar
- Department of Psychology and Neuropsychology Doctoral Sub-Program, Queens College, City University of New York, Flushing, NY 11367, United States.
| |
Collapse
|
17
|
Daniulaityte R, Falck R, Carlson RG. Illicit use of buprenorphine in a community sample of young adult non-medical users of pharmaceutical opioids. Drug Alcohol Depend 2012; 122:201-7. [PMID: 22036303 PMCID: PMC3293107 DOI: 10.1016/j.drugalcdep.2011.09.029] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2011] [Revised: 09/29/2011] [Accepted: 09/30/2011] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is growing evidence about illicit use of buprenorphine in the U.S. The study aims to: (1) identify prevalence and predictors of illicit buprenorphine use in a community sample of 396 young adult (18-23 years old) non-medical users of pharmaceutical opioids and (2) describe knowledge, attitudes and behaviors linked to illicit buprenorphine use as reported by a qualitative sub-sample (n=51). METHODS Participants were recruited using respondent-driven sampling. Qualitative interview participants were selected from the larger sample. The sample (n=396) was 54% male and 50% white; 7.8% reported lifetime illicit use of buprenorphine. RESULTS Logistic regression analysis results indicate that white ethnicity, intranasal inhalation of pharmaceutical opioids, symptoms of opioid dependence, and a greater number of pharmaceutical opioids used in lifetime were statistically significant predictors of illicit buprenorphine use. Qualitative interviews revealed that buprenorphine was more commonly used by more experienced users who were introduced to it by their "junkie friends." Those who used buprenorphine to self-medicate withdrawal referred to it as a "miracle pill." When used to get high, reported experiences ranged from "the best high ever" to "puking for days." Participants reported using buprenorphine/naloxone orally or by intranasal inhalation. Injection of buprenorphine without naloxone was also reported. CONCLUSION Our findings suggest that illicit buprenorphine use is gaining ground primarily among whites and those who are more advanced in their drug use careers. Continued monitoring is needed to better understand evolving patterns and trends of illicit buprenorphine use.
Collapse
Affiliation(s)
- Raminta Daniulaityte
- Center for Interventions, Treatment, and Addictions Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, Dayton, OH 45435, United States.
| | - Russel Falck
- Center for Interventions, Treatment, and Addiction Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, 3640 Colonel Glenn Hwy., Dayton, OH 45435, tel.: 937-775-2066, fax: 937-775-2214
| | - Robert G. Carlson
- Center for Interventions, Treatment, and Addiction Research, Department of Community Health, Boonshoft School of Medicine, Wright State University, 3640 Colonel Glenn Hwy., Dayton, OH 45435, tel.: 937-775-2066, fax: 937-775-2214
| |
Collapse
|
18
|
Yokell MA, Zaller ND, Green TC, Rich JD. Buprenorphine and buprenorphine/naloxone diversion, misuse, and illicit use: an international review. CURRENT DRUG ABUSE REVIEWS 2011; 4:28-41. [PMID: 21466501 PMCID: PMC3154701 DOI: 10.2174/1874473711104010028] [Citation(s) in RCA: 176] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2011] [Accepted: 03/24/2011] [Indexed: 11/22/2022]
Abstract
The diversion, misuse, and non-medically supervised use of buprenorphine and buprenorphine/naloxone by opioid users are reviewed. Buprenorphine and buprenorphine/naloxone are used globally as opioid analgesics and in the treatment of opioid dependency. Diversion of buprenorphine and buprenorphine/naloxone represents a complex medical and social issue, and has been widely documented in various geographical regions throughout the world. We first discuss the clinical properties of buprenorphine and its abuse potential. Second, we discuss its diversion and illicit use on an international level, as well as motivations for those activities. Third, we examine the medical risks and benefits of buprenorphine's non-medically supervised use and misuse. These risks and benefits include the effect of buprenorphine's use on HIV risk and the risk of its concomitant use with other medications and drugs of abuse. Finally, we discuss the implications of diversion, misuse, and non-medically supervised use (including potential measures to address issues of diversion); and potential areas for further research.
Collapse
Affiliation(s)
- Michael A. Yokell
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI 02906, USA
- Center for AIDS Research, The Miriam Hospital, Providence, RI 02906, USA
| | - Nickolas D. Zaller
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI 02906, USA
- Center for AIDS Research, The Miriam Hospital, Providence, RI 02906, USA
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| | - Traci C. Green
- Center for AIDS Research, The Miriam Hospital, Providence, RI 02906, USA
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
- Rhode Island Hospital, Providence, RI 02903, USA
| | - Josiah D. Rich
- Division of Infectious Diseases, The Miriam Hospital, Providence, RI 02906, USA
- Center for AIDS Research, The Miriam Hospital, Providence, RI 02906, USA
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA
| |
Collapse
|