Background: Hepatitis C virus (HCV) is the most prevalent chronic viral illness in the United States. Many individuals with virus HCV are opioid dependent requiring treatment with opiate substitution treatment such as buprenorphine. Previous reports in the literature have suggested hepatotoxicity with buprenorphine tempering initial enthusiasm of the safety of buprenorphine in HCV-infected patients.
Methods: As part of an ongoing SAMHSA-funded grant to expand opiate substitution therapy with buprenorphine, all opioid-dependent patients seeking treatment with buprenorphine undergo a laboratory evaluation including transaminases (AST/ALT) as well as laboratory evaluation for acute and chronic hepatitis.
Results: Of the 121 patients screened for entry into buprenorphine treatment, 4 patients had evidence of acute HCV infection.
Conclusions: Despite markedly elevated transaminases in the setting of acute hepatitis C infection, these patients tolerated buprenorphine treatment with improvement in their transaminases during the course of buprenorphine treatment.
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http://dx.doi.org/10.1080/00952990701653875 | DOI Listing |
Drug Alcohol Depend
January 2025
Fralin Biomedical Research Institute at Virginia Tech Carilion, 2 Riverside Circle, Roanoke, VA 24016, United States.
Background: Opioid use disorder (OUD) continues to pose a significant challenge to public health in the United States. Chronic pain and OUD are highly comorbid conditions, yet few studies have examined the relative associations of pain status and severity toward multidimensional OUD recovery outcomes (e.g.
View Article and Find Full Text PDFJ Psychoactive Drugs
January 2025
McGaw Medical Center, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Co-occurring substance use disorders are common in medical settings, yet limited literature exists on concomitant pharmacological management. We present a case where low-dose buprenorphine induction (LDBI) and rapid phenobarbital taper were performed concurrently in a hospital setting to manage co-occurring opioid dependence (on chronic methadone maintenance therapy) and benzodiazepine dependence (prescribed alprazolam). The simultaneous management was well-tolerated and completed with minimal complications, successfully enabling candidacy for the patient's preferred disposition.
View Article and Find Full Text PDFDrug Alcohol Depend Rep
March 2025
Institute for Drug and Alcohol Studies, Virginia Commonwealth University, 203 East Cary Street, Richmond, VA 23219, USA.
Background: Evidence supports the common incidence of sleep disturbance in opioid use disorder (OUD) as a potential marker of disrupted orexin system functioning. This study evaluated the initial safety and tolerability of a challenge dose of lemborexant, a dual orexin antagonist, as an adjunct to buprenorphine/naloxone.
Methods: Patients (18-65 years old) with OUD receiving sublingual buprenorphine/naloxone, with a Pittsburgh Sleep Quality Index total score of 6 or higher, were recruited from outpatient clinics.
Ann Fam Med
January 2025
Department of Family Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado.
Purpose: Offering medication for opioid use disorder (MOUD) in primary care can increase access to effective opioid use disorder treatment and help address the US opioid crisis. We describe a primary care office-based opioid treatment program and addiction consultation service model designed to support small, rural clinics to increase their capacity for MOUD.
Methods: This is an evaluation of an intervention to increase clinic capacity to offer MOUD.
Subst Use Addctn J
January 2025
Behavioral Health Network - St. Louis, St. Louis, MO, USA.
Background: In 2020, loosened federal regulations allowed for buprenorphine for opioid use disorder to be initiated via telemedicine. In response to these regulatory changes and growing racial inequities in overdose in St. Louis, MO, a local, peer-led outreach program incorporated a new rapid access (RA) to buprenorphine program.
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