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The Next Stage of Buprenorphine Care for Opioid Use Disorder.
Martin, Stephen A; Chiodo, Lisa M; Bosse, Jordon D; Wilson, Amanda.
Affiliation
  • Martin SA; University of Massachusetts Medical School and Barre Family Health Center, Barre, and CleanSlate Research and Education Foundation, Florence, Massachusetts (S.A.M.).
  • Chiodo LM; University of Massachusetts Amherst College of Nursing, Amherst, and CleanSlate Research and Education Foundation, Florence, Massachusetts (L.M.C., J.D.B.).
  • Bosse JD; University of Massachusetts Amherst College of Nursing, Amherst, and CleanSlate Research and Education Foundation, Florence, Massachusetts (L.M.C., J.D.B.).
  • Wilson A; CleanSlate Research and Education Foundation, Florence, Massachusetts (A.W.).
Ann Intern Med ; 169(9): 628-635, 2018 11 06.
Article in En | MEDLINE | ID: mdl-30357262
ABSTRACT
Buprenorphine has been used internationally for the treatment of opioid use disorder (OUD) since the 1990s and has been available in the United States for more than a decade. Initial practice recommendations were intentionally conservative, were based on expert opinion, and were influenced by methadone regulations. Since 2003, the American crisis of OUD has dramatically worsened, and much related empirical research has been undertaken. The findings in several important areas conflict with initial clinical practice that is still prevalent. This article reviews research findings in the following 7 areas location of buprenorphine induction, combining buprenorphine with a benzodiazepine, relapse during buprenorphine treatment, requirements for counseling, uses of drug testing, use of other substances during buprenorphine treatment, and duration of buprenorphine treatment. For each area, evidence for needed updates and modifications in practice is provided. These modifications will facilitate more successful, evidence-based treatment and care for patients with OUD.
Subject(s)

Full text: 1 Database: MEDLINE Main subject: Buprenorphine / Evidence-Based Medicine / Opiate Substitution Treatment / Narcotic Antagonists / Opioid-Related Disorders Type of study: Guideline Limits: Humans Language: En Year: 2018 Type: Article

Full text: 1 Database: MEDLINE Main subject: Buprenorphine / Evidence-Based Medicine / Opiate Substitution Treatment / Narcotic Antagonists / Opioid-Related Disorders Type of study: Guideline Limits: Humans Language: En Year: 2018 Type: Article