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Direct Induction of Buprenorphine Extended-Release: A Case Report.
J Addict Med
December 2024
From the Integrated Psychiatry, Pain, and Addiction Service, Vancouver General Hospital, Vancouver, British Columbia, Canada (PA, JSHW, JM, MN, VWL, MJI, NM); Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (PA, MN, VWL, MJI, NM); Addictions and Concurrent Disorders Research Group, Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada (JSHW, RMK); Substance Use Response and Facilitation Service, BC Children's Hospital, Provincial Health Services Authority, Vancouver, British Columbia, Canada (MJI); BC Mental Health & Substance Use Services, Provincial Health Services Authority, Vancouver, British Columbia, Canada (NM); Bridge, Public Health Institute, Oakland, CA (AAH); Department of Emergency Medicine, Highland General Hospital-Alameda Health System, Oakland, CA (AAH); Department of Emergency Medicine, University of California, San Francisco, CA (AAH); The C4 Foundation, Coronado, CA (RM); British Columbia Centre for Excellence in HIV/AIDS, Vancouver, British Columbia, Canada (JSGM); Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada (JSGM); and Pharmacokinetics Modeling and Simulation Laboratory, Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada (ARM).
Buprenorphine has superior safety in opioid use disorder compared with alternatives due to its action as a partial opioid agonist, which limits its ability to cause respiratory depression. There is a risk of precipitated opioid withdrawal after buprenorphine exposure in someone using full opioid agonists. Buprenorphine induction strategies that avoid precipitated withdrawal remain a crucial component for starting buprenorphine in individuals actively using opioids.
View Article and Find Full Text PDFIncreased Prevalence of Skeletal Anomalies on Ultrasound Evaluation of Buprenorphine-Exposed Human Fetuses.
South Med J
January 2025
Department of Obstetrics and Gynecology, East Tennessee State University, Johnson City.
Objectives: In this study, buprenorphine was the primary source of maternal opioid exposure at the time of initial prenatal evaluation. Current recommendations advise that level II ultrasounds be performed in patients with substance use disorders. For some patients, distance, transportation, and costs associated with obtaining ultrasounds from a specialist pose significant barriers.
View Article and Find Full Text PDFState Medicaid Policies Governing Access to Medications for Opioid Use Disorder (MOUD) and MOUD Treatment Use in a Large Sample of People Who Inject Drugs in 20 U.S. States.
Subst Use Misuse
December 2024
Department of Health Policy and Management, Rollins School of Public Health at Emory University, Atlanta, GA, USA.
Background: People who inject drugs (PWID) are especially vulnerable to harms from opioid use disorder (OUD). Medications for OUD (MOUD) effectively reduce overdose and infectious disease transmission risks.
Objective: We investigate whether state Medicaid coverage for methadone and buprenorphine is related to past-year MOUD use among PWID using cross-sectional, multilevel analyses with individual-level data on PWID from the Centers for Disease Control and Prevention's 2018 National HIV Behavioral Surveillance.
An Approach for Improving the Detection and Quantitation of Buprenorphine and Its Metabolites in Maternal and Neonatal Hair.
Ther Drug Monit
December 2024
Department of Pharmaceutical Sciences, School of Pharmacy, University of Pittsburgh, Pittsburgh, Pennsylvania.
Background: Buprenorphine (BUP) use is prevalent in pregnant women with opioid use disorder (OUD). Drug monitoring during pregnancy is critical for optimizing dosing regimen and achieving the desired clinical outcomes. Hair can be used as a critical biological matrix for monitoring long-term exposure to drugs.
View Article and Find Full Text PDFDifferential Effects of Prenatal Buprenorphine and Methadone on Postnatal Growth and Gene Expression in the Nucleus Accumbens.
Dev Psychobiol
January 2025
Department of Comparative Pathobiology, Cummings School of Veterinary Medicine, Tufts University, North Grafton, Massachusetts, USA.
Article Synopsis
- Methadone and buprenorphine are used during pregnancy to help women with opioid use disorder, but babies exposed to these medications may experience neonatal opioid withdrawal syndrome (NOWS), affecting their feeding behavior.
- A study involving pregnant female rats showed that offspring exposed to either drug had lower weights compared to those given saline, with buprenorphine offspring maintaining lower weights longer than those exposed to methadone.
- Gene expression analysis indicated that while both drugs had similar effects, methadone-exposed offspring exhibited significantly reduced levels of the gene proopiomelanocortin (Pomc), suggesting different developmental impacts between the two medications.
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