BACKGROUND: While numerous studies support the efficacy of methadone and buprenorphine for the stabilization and maintenance of opioid dependence, clinically significant opioid withdrawal symptoms occur upon tapering and cessation of dosage. METHODS: We present a case study of a 35 year old Caucasian female (Krissie) who was prescribed increasing dosages of prescription opioids after carpel tunnel surgery secondary to chronic pain from reflex sympathetic dystrophy and fibromyalgia. Over the next 5 years, daily dosage requirements increased to over 80 mg of Methadone and 300 ug/hr Fentanyl transdermal patches, along with combinations of 12-14 1600 mcg Actig lollipop and oral 100 mg Morphine and 30 mg oxycodone 1-2 tabs q4-6hr PRN for breakthrough pain. Total monthly prescription costs including supplemental benzodiazepines, hypnotics and stimulants exceeded $50,000. The patient was subsequently transferred to Suboxone® in 2008, and the dosage was gradually tapered until her admission for inpatient detoxification with KB220Z a natural dopaminergic agonist. We carefully documented her withdrawal symptoms when she precipitously stopped taking buprenorphine/naloxone and during follow-up while taking KB220Z daily. We also genotyped the patient using a reward gene panel including (9 genes 18 alleles): DRD 2,3,4; MOA-A; COMT; DAT1; 5HTTLLR; OPRM1; and GABRA3. FINDINGS: At 432 days post Suboxone® withdrawal the patient is being maintained on KB220Z, has been urine tested and is opioid free. Genotyping data revealed a moderate genetic risk for addiction showing a hypodopaminergic trait. This preliminary case data suggest that the daily use of KB220Z could provide a cost effective alternative substitution adjunctive modality for Suboxone®. We encourage double-blind randomized -placebo controlled studies to test the proposition that KB220Z may act as a putative natural opioid substitution maintenance adjunct.
RCT Entities:
BACKGROUND: While numerous studies support the efficacy of methadone and buprenorphine for the stabilization and maintenance of opioid dependence, clinically significant opioid withdrawal symptoms occur upon tapering and cessation of dosage. METHODS: We present a case study of a 35 year old Caucasian female (Krissie) who was prescribed increasing dosages of prescription opioids after carpel tunnel surgery secondary to chronic pain from reflex sympathetic dystrophy and fibromyalgia. Over the next 5 years, daily dosage requirements increased to over 80 mg of Methadone and 300 ug/hr Fentanyl transdermal patches, along with combinations of 12-14 1600 mcg Actig lollipop and oral 100 mg Morphine and 30 mg oxycodone 1-2 tabs q4-6hr PRN for breakthrough pain. Total monthly prescription costs including supplemental benzodiazepines, hypnotics and stimulants exceeded $50,000. The patient was subsequently transferred to Suboxone® in 2008, and the dosage was gradually tapered until her admission for inpatient detoxification with KB220Z a natural dopaminergic agonist. We carefully documented her withdrawal symptoms when she precipitously stopped taking buprenorphine/naloxone and during follow-up while taking KB220Z daily. We also genotyped the patient using a reward gene panel including (9 genes 18 alleles): DRD 2,3,4; MOA-A; COMT; DAT1; 5HTTLLR; OPRM1; and GABRA3. FINDINGS: At 432 days post Suboxone® withdrawal the patient is being maintained on KB220Z, has been urine tested and is opioid free. Genotyping data revealed a moderate genetic risk for addiction showing a hypodopaminergic trait. This preliminary case data suggest that the daily use of KB220Z could provide a cost effective alternative substitution adjunctive modality for Suboxone®. We encourage double-blind randomized -placebo controlled studies to test the proposition that KB220Z may act as a putative natural opioid substitution maintenance adjunct.
Authors: Kenneth Blum; Thomas J H Chen; John Bailey; Abdalla Bowirrat; John Femino; Amanda L C Chen; Thomas Simpatico; Siobhan Morse; John Giordano; Uma Damle; Mallory Kerner; Eric R Braverman; Frank Fornari; B William Downs; Cynthia Rector; Debmayla Barh; Marlene Oscar-Berman Journal: Mol Neurobiol Date: 2011-09-24 Impact factor: 5.590
Authors: Kenneth Blum; Marcelo Febo; Lyle Fried; Mona Li; Kristina Dushaj; Eric R Braverman; Thomas McLaughlin; Bruce Steinberg; Rajendra D Badgaiyan Journal: Subst Use Misuse Date: 2016-12-29 Impact factor: 2.164
Authors: Kenneth Blum; Edward J Modestino; Marjorie Gondre-Lewis; Edwin J Chapman; Jennifer Neary; David Siwicki; David Baron; Mary Hauser; David E Smith; Alphonse Kenison Roy; Panayotis K Thanos; Bruce Steinberg; Thomas McLaughlin; Lyle Fried; Debmalya Barh; Georgia A Dunston; Rajendra D Badgaiyan Journal: Int J Genom Data Min Date: 2018-01-15
Authors: Kenneth Blum; Ali Raza; Tiffany Schultz; Rehan Jalali; Richard Green; Raymond Brewer; Panyotis K Thanos; Thomas McLaughlin; David Baron; Abdalla Bowirrat; Igor Elman; B William Downs; Debasis Bagchi; Rajendra D Badgaiyan Journal: Acta Sci Neurol Date: 2021-02-02
Authors: Thomas McLaughlin; Kenneth Blum; Marlene Oscar-Berman; Marcelo Febo; Gozde Agan; James L Fratantonio; Thomas Simpatico; Mark S Gold Journal: J Behav Addict Date: 2015-06 Impact factor: 6.756
Authors: Kenneth Blum; Debra Whitney; Lye Fried; Marcelo Febo; Roger L Waite; Eric R Braverman; Kristina Dushaj; Mona Li; John Giordano; Zsolt Demetrovics; Rajendra D Badgaiyan Journal: Clin Med Rev Case Rep Date: 2016-08-16
Authors: Kenneth Blum; Marlene Oscar-Berman; Seth H Blum; Margaret A Madigan; Roger L Waite; Thomas McLaughlin; Debmalya Barh Journal: J Alcohol Drug Depend Date: 2014-05-29
Authors: Kenneth Blum; Lyle Fried; Margaret A Madigan; John Giordano; Edward J Modestino; Bruce Steinberg; David Baron; Michael DeLeon; Thomas McLaughlin; Mary Hauser; Rajendra D Badgaiyan Journal: Glob J Addict Rehabil Med Date: 2017-04-27