Buprenorphine/naloxone (Suboxone) Research Papers

Abstract Introduction: The most modern medically assisted method of substitution treatment of opiate dependants with Buprenorphine/Naloxone (Suboxone) has been implemented in Department of Psychiatry in Tuzla from 27 July 2009. The... more

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- by Mevludin Hasanovic and +1
  Alija Sutović
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- 3
  Drugs And Addiction, Quality of life, Buprenorphine/naloxone (Suboxone)

The research presented in this thesis focuses on the lived experience of people on opioid substitution programmes in the Greek Organization Against Drugs (OKANA) in Athens. The participants were in treatment over a long period on an... more

The research presented in this thesis focuses on the lived experience of people on opioid substitution programmes in the Greek Organization Against Drugs (OKANA) in Athens. The participants were in treatment over a long period on an extremely low dosage of buprenorphine. This research aimed to gain in-depth accounts of the lived experience of people on low maintenance and how they understand their long-term stay on drug substitutes. Seven semi-structured interviews were audiotaped and transcribed. Interpretative Phenomenological Analysis (IPA) procedures were used to analyse the interview data and to explore how opioid-addicted individuals described their lives before and during the maintenance program. Three superordinate themes emerged from the analysis: (1) moving on from the chaos of usage to the reality of substitution; (2) the substitution programme, a productive constraint; and (3) the future as a prolonged present. The participants described their participation in the drug substitution programme as a ‘rescue solution', as it marked the departure from ‘chaos’ and the passage to a refuge. The participants’ accounts also underline the presence of contradictions and ambivalence in the way that they experience their long-term involvement in therapy. On the one hand, as they described how the programme covers their physical need for the substance, giving them a sense of an ‘almost normal self,' while, on the other hand, they narrate how they are ‘captive’ of the drug and their personal and the therapeutic programme’s limitations. Within this framework, the continuation of the lowest possible dose of the substitute was construed by participants as a ‘safety valve’ in order to be able to maintain in the least binding way the stability that substitution programme offers them. Future research would do well to focus on exploring people’s experiences in different phases of substitution therapy treatment.
Key Words: Addiction, substitution therapy, buprenorphine, harm reduction, institutional identities, formula stories, chronic addict

The United States is in the midst of a public health crisis: Every year, well over 24,000 Americans die from opioid overdose. This staggering death toll is equivalent to a weekly jumbo jet crash. After a decade of rapid growth, overdose... more

The United States is in the midst of a public health crisis: Every year, well over 24,000 Americans die from opioid overdose. This staggering death toll is equivalent to a weekly jumbo jet crash. After a decade of rapid growth, overdose caused by prescription opioids and heroin now tops the accidental death rankings, beating out automobile accidents, AIDS, and other high-profile killers. Overdose does not discriminate, cutting across all geographic, economic, and racial divides. But some groups are especially vulnerable. This article is dedicated to one such group: individuals re-entering the community from correctional settings. In the immediate two weeks after release, people in this group are almost 130 times more likely to die of an overdose than the general population.

It is easy to cast post-incarceration substance use — and consequent overdose — as the re-entering individual’s character weakness or a propensity towards reckless behavior. Nevertheless, modern addiction science reframes such relapse as a foreseeable consequence of the chronic nature of substance use disorders. This scientific evidence also provides clear guidance on how most of the resulting fatalities can be prevented. This article considers the creation of fatal overdose risk among formerly incarcerated individuals as an unacceptable collateral harm emanating from criminal justice involvement.

In order to address this largely overlooked public health problem, we explore a range of legal channels that can help persuade the state (broadly construed) to address a risk to which it substantially contributes. We consider a number of doctrinal approaches, guided by the belief that spending time behind bars must not translate to a death sentence for so many Americans. Whether as a part of possible legal actions or an action agenda on its own right, we present a number of programmatic interventions and policy reforms that may alleviate this crisis. Our analysis also highlights the potential role of the Affordable Care Act (ACA) in facilitating overdose prevention before, during and post-incarceration. This agenda is especially timely given the current move by federal and state governments towards releasing large numbers of individuals incarcerated on drug-related charges to ease prison over-crowding or as a result of legal reforms, pardons, or exonerations.

In Section I, we provide an overview of the opioid overdose epidemic and the special vulnerability among criminal justice-involved individuals. In Section II, we examine the scientific evidence on prevention measures that should be, but are currently rarely deployed to address this vulnerability. In Section III, we explore various legal theories that could be invoked in efforts to motivate government actors to take a greater responsibility for preventing post-incarceration overdose deaths. In Section IV, we cover additional mechanisms to motivate institutional change. We conclude by outlining a policy and programmatic agenda for reducing the vulnerability of criminal justice-involved individuals to opioid overdose.

Emesis, also known as nausea and vomiting, are common symptoms associated with ingestion of toxicants, drug side effects, advanced terminal diseases such as cancer and postoperative procedures. Emesis is mediated through the coordinated... more

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- by Salman Ahmed
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- 138
  Natural Products, Natural Products Chemistry, Africa, Dog Behavior

Célkitűzések: Vizsgálatunk célja a Suboxone-szubsztitúcióban kezelt kliensek vezető pszichológiai tüneteiben (szorongás, depresszió, sóvárgás) történt változások felmérése volt az első fél éves terápia alatt, valamint ezt követően a... more

Medication-assisted treatment (MAT) is an effective intervention used to treat opioid use disorder. Patients are often unable to access MAT, however, due to many legal, financial, and cultural barriers. Buprenorphine is a safe,... more

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- by Marina Haque
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- 5
  Mental Health, Health Equity, Public policies, Opioids

Buprenorphine is now being detected as a drug of abuse in drugs/driving cases alongside side naloxone. Being a semi synthetic opiate, it has the potential to impair motorists in a similar fashion to morphine. Many laboratories have... more

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- by Casey Anderson
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- 8
  Pharmacology, Psychology, Clinical Psychology, Social Psychology

Background Conducted in the Dayton Metropolitan area of Southwestern Ohio, this qualitative study explores the self-treatment practices of people who use illicit opioids (PWUIO) amidst the new risk environment produced by illicit,... more

Background
Conducted in the Dayton Metropolitan area of Southwestern Ohio, this qualitative study explores the self-treatment practices of people who use illicit opioids (PWUIO) amidst the new risk environment produced by illicit, non-pharmaceutical fentanyl (NPF). We explore local perceptions of the presence of NPF in the Dayton area, and how this has both positively and negatively impacted practices of non-prescribed buprenorphine use among PWUIO.

Methods
This study analyzes qualitative data from 63 interviews conducted between October 2018 and June 2019. Participants were selected from a larger longitudinal study on non-prescribed buprenorphine use among individuals with opioid use disorder. Qualitative interviews were transcribed in their entirety, and their transcriptions were analyzed using NVivo software, drawing on a mix of thematic and inductive coding.

Results
Interview respondents ranged from 19 to 70 years old, with a mean age of 38.9 years. 54% of them were male, and 85.7% identified as non-Hispanic White. 98.4% of the sample had used heroin, and 93.7% of the sample reported use of NPF. Participants agreed NPF dominated the illicit opioids market in the area, and was perceived as both dangerous and desirable. The domination of NPF and associated overdose experiences prompted some to seek positive change and initiate self-treatment with non-prescribed buprenorphine. For others, NPF sabotaged established practices of harm reduction, as unanticipated experiences of precipitated withdrawals prompted some participants to give up non-prescribed buprenorphine use as a tactic of self-treatment.

Discussion
The changing nature of heroin/NPF necessarily gives rise to new beliefs surrounding self-treatment attempts, treatment seeking behaviors, and harm reduction practices. While buprenorphine treatment continues to offer promising results for treating opioid use disorders, it is urgent to reconsider how the unpredictable biochemical mixture of NPFs circulating on the streets today may impact the initiation and success of treatment.

Although the rate of opioid abuse in Turkey is lower than that in North America and Europe, opioid abuse is an increasing public health problem in Turkey. This is because of both the use of heroin and the increasing number of individuals... more

The Specific Aims of this application are to use a paradigmatic approach that combines Semantic Web technology, Natural Language Processing and Machine Learning techniques to: 1) Describe drug users' knowledge, attitudes, and behaviors... more

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- by Amit Sheth
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- 3
  Semantic Web, Drug abuse, Buprenorphine/naloxone (Suboxone)

Drawing on a multisite sample of 40 persons who sell, share, or use diverted buprenorphine to manage opioid use disorder, in this study we describe why individuals seek to obtain buprenorphine outside of formal treatment contexts, and... more

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- by Philip Kavanaugh
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- 6
  Harm Reduction, Buprenorphine, Opioid Substitution Therapy, Suboxone

IMPORTANCE In the United States, access to medications prescribed for opioid use disorder (OUD) is lower in rural counties than in urban counties. Considering the positive associations between direct-to-physician promotion of opiates and... more

IMPORTANCE In the United States, access to medications prescribed for opioid use disorder (OUD) is lower in rural counties than in urban counties. Considering the positive associations between direct-to-physician promotion of opiates and OUD medications and their prescribing rates, a study examining the association between pharmaceutical promotion of these medications and county-level rurality has merit. OBJECTIVE To assess whether rural counties received less pharmaceutical promotion of OUD medications compared with urban counties. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional county-level study used all reported direct-to-physician pharmaceutical payments from manufacturers of medications prescribed for OUD from January 1, 2014, through December 31, 2017, as well as demographic and economic data at the county level from 3140 US counties. Logistic regression was used with year and state-level fixed effects to compare rural county and urban county odds of receiving any promotion of OUD medications. A negative binomial model was used with year and state-level fixed effects to compare the mean pharmaceutical payments per physician and per population in rural vs urban counties. MAIN OUTCOMES AND MEASURES A binary indicator for whether physicians in a county received any promotion related to OUD medications in a year. The second outcome was the value of promotion (eg, meals), with dollar amount of payments for each county by year. Counties were separated into metropolitan, micropolitan, and rural categories using the National Center for Health Statistics Urban-Rural Classification Scheme. RESULTS Of 3140 US counties with 18 318 physicians to whom promotion of OUD medications was directed, 1166 (37.1%) were metropolitan (16 740 physicians [91.4%]), 641 (20.4%) were micropolitan (1049 physicians [5.7%]), and 1333 (42.5%) were rural (529 physicians [2.9%]). Compared with physicians in metropolitan counties, physicians in rural counties had reduced odds of receiving any promotion (adjusted odds ratio, 0.57; 95% CI, 0.44-0.74) and received lower payments (adjusted incidence rate ratio, 0.24; 95% CI, 0.17-0.34). CONCLUSIONS AND RELEVANCE The study findings suggest that promotion for OUD medications is less likely to occur in rural counties and that this difference in promotion of OUD medications may be associated with differential commercial costs and benefits of promotion in rural settings. Question Is there an association between county-level rurality and direct-to-physician commercial promotion of medications prescribed for opioid use disorder? Findings In this cross-sectional study of 3140 US counties from 2014 to 2017, among 18 318 physicians to whom promotion of opioid use disorder medications was directed, rural counties were less likely to receive any promotion, and receive lower payments compared with those in urban counties. Meaning The findings suggest that the commercial promotion of medications prescribed for opioid use disorder is less likely to occur in rural counties and that the difference may be associated with differential commercial costs and benefits of promotion in these areas.

Recently, there has been greater emphasis on the management of "addiction" and substance use disorders with pharmacological treatments. For example, Medication-Assisted Treatments (MAT), such as methadone and buprenorphine for opioid... more

Buprenorphine/naloxone (B/N) therapy is a prescription pharmacotherapy for opioid dependence. For certain health service providers, when B/N escapes supervision and diverts into the hands of people for whom it is unintended, it can pose... more

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- by Jia-shin Chen
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- 5
  Harm Reduction, Drug Policy, Taiwan, Assemblage Theory

Orange County Suboxone doctors and treatment options.

Introduction: The opioid overdose crisis in the United States has prompted an expansion of treatment services, including pharmacotherapy with buprenorphine. However, many people who use illicit opioids (PWUIO) self-treat their opioid-use... more

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- by Joseph Wettstein
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- 3
  Buprenorphine/naloxone (Suboxone), Naltrexone, Naloxone

The programme helps families to rebuild their homes and relationships torn-apart by addictions, through rehabilitation, re-socialization and reintegration. This centre is a result of several years of cooperation between the Tuzla... more

Buprenorphine/naloxone (Suboxone)

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