OBJECTIVE: To review the current evidence on buprenorphine-naloxone for the treatment of opioid-related disorders, with a focus on primary care settings. QUALITY OF EVIDENCE: MEDLINE and the Cochrane Database of Systematic Reviews were searched. Evidence is mainly level I. MAIN MESSAGE: Buprenorphine is a partial μ-opioid agonist and κ-opioid antagonist with a long half-life and less abuse potential than methadone. For detoxification, buprenorphine is at least equivalent to methadone and is superior to clonidine. For maintenance treatment, buprenorphine is clearly superior to placebo. Methadone has a slight advantage in terms of retention in treatment, but a stepped approach with initial use of buprenorphine-naloxone is as efficacious. Use of buprenorphine in the primary care setting is feasible, safe, and effective. Authorization to prescribe buprenorphine can be obtained after completing online training. CONCLUSION: Buprenorphine is a safe and effective agent for detoxification from opioids. It can be used as a first-line agent in maintenance programs, owing to its lower abuse potential relative to other opioids. Its effectiveness in primary care settings makes it a useful therapeutic tool for family physicians.
OBJECTIVE: To review the current evidence on buprenorphine-naloxone for the treatment of opioid-related disorders, with a focus on primary care settings. QUALITY OF EVIDENCE: MEDLINE and the Cochrane Database of Systematic Reviews were searched. Evidence is mainly level I. MAIN MESSAGE: Buprenorphine is a partial μ-opioid agonist and κ-opioid antagonist with a long half-life and less abuse potential than methadone. For detoxification, buprenorphine is at least equivalent to methadone and is superior to clonidine. For maintenance treatment, buprenorphine is clearly superior to placebo. Methadone has a slight advantage in terms of retention in treatment, but a stepped approach with initial use of buprenorphine-naloxone is as efficacious. Use of buprenorphine in the primary care setting is feasible, safe, and effective. Authorization to prescribe buprenorphine can be obtained after completing online training. CONCLUSION:Buprenorphine is a safe and effective agent for detoxification from opioids. It can be used as a first-line agent in maintenance programs, owing to its lower abuse potential relative to other opioids. Its effectiveness in primary care settings makes it a useful therapeutic tool for family physicians.
Authors: Shannon Gwin Mitchell; Sharon M Kelly; Barry S Brown; Heather Schacht Reisinger; James A Peterson; Adrienne Ruhf; Michael H Agar; Kevin E O'Grady; Robert P Schwartz Journal: Am J Addict Date: 2009 Sep-Oct
Authors: D Andrew Tompkins; George E Bigelow; Joseph A Harrison; Rolley E Johnson; Paul J Fudala; Eric C Strain Journal: Drug Alcohol Depend Date: 2009-08-03 Impact factor: 4.492
Authors: Traci R Rieckmann; Nicholas Gideonse; Amanda Risser; Jennifer E DeVoe; Amanda J Abraham Journal: J Behav Health Serv Res Date: 2017-07 Impact factor: 1.505
Authors: Petra Jacobs; Alfonso Ang; Maureen P Hillhouse; Andrew J Saxon; Suzanne Nielsen; Paul G Wakim; Barbara E Mai; Larissa J Mooney; Jennifer S Potter; Jack D Blaine Journal: Am J Addict Date: 2015-09-24
Authors: Yi Zheng; Samuel Obeng; Huiqun Wang; Abdulmajeed M Jali; Bharath Peddibhotla; Dwight A Williams; Chuanchun Zou; David L Stevens; William L Dewey; Hamid I Akbarali; Dana E Selley; Yan Zhang Journal: J Med Chem Date: 2019-01-11 Impact factor: 7.446
Authors: Traci R Rieckmann; Amanda J Abraham; Anne E Kovas; Bentson H McFarland; Paul M Roman Journal: Addict Behav Date: 2014-02-07 Impact factor: 3.913
Authors: Denise M Boudreau; Gwen Lapham; Eric A Johnson; Jennifer F Bobb; Abigail G Matthews; Jennifer McCormack; David Liu; Cynthia I Campbell; Rebecca C Rossom; Ingrid A Binswanger; Bobbi Jo Yarborough; Julia H Arnsten; Chinazo O Cunningham; Joseph E Glass; Mark T Murphy; Mohammad Zare; Rulin C Hechter; Brian Ahmedani; Jordan M Braciszewski; Viviana E Horigian; José Szapocznik; Jeffrey H Samet; Andrew J Saxon; Robert P Schwartz; Katharine A Bradley Journal: J Subst Abuse Treat Date: 2020-03