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Dosing and Misuse of Buprenorphine in the New Jersey Department of Corrections.
J Am Acad Psychiatry Law
December 2024
Dr. Tamburello is Associate Director of Psychiatry, University Correctional Health Care, and Clinical Professor of Psychiatry, Department of Psychiatry, Rutgers-Robert Wood Johnson Medical School, Piscataway, NJ, USA. Dr. Martin is a staff psychiatrist, VA Pittsburgh Healthcare System, Washington, D.C., USA.
Opioid use disorder is common in incarcerated persons, and concern about the diversion of buprenorphine is a barrier to treatment. We conducted a retrospective chart review of incarcerated persons in the New Jersey Department of Corrections who received charges for misuse of medication, including buprenorphine, hypothesizing that the prescription of buprenorphine monoproduct, multiple tabs or films of buprenorphine, or higher doses of buprenorphine would be associated with more diversion incidents. Within the dosing range of 2 to 12 mg, there were more incidents of diversion of buprenorphine monoproduct (24.
View Article and Find Full Text PDFBuprenorphine/naloxone - one formulation that doesn't fit all: a case report.
Harm Reduct J
July 2024
Colorado Coalition for the Homeless, Denver, CO, USA.
Background: Sublingual buprenorphine, approved for treatment of opioid use disorder since 2002, is most commonly available in co-formulation with naloxone. Naloxone is an opioid antagonist minimally absorbed when sublingual (SL) buprenorphine/naloxone is taken as prescribed; it is thought to reduce potential for misuse via intravenous administration. However, growing data and clinical experience demonstrate that previously accepted assumptions about the pharmacokinetics of these medications may not apply to all patients.
View Article and Find Full Text PDFLegislative and regulatory barriers to pharmacies dispensing buprenorphine for OUD.
J Opioid Manag
January 2023
Roan Mountain Pharmacy, Roan Mountain, Tennessee.
Introduction: Buprenorphine (BUP) is increasingly recognized and utilized as a valuable medication for the treatment of opioid use disorder. This article focuses on the problem of regulatory restrictions on access to buprenorphine products without naloxone (mono-product), involving patients in one geographic area, but which may represent a more general access problem in the United States.
Design: In response to an audit by the Tennessee Board of Pharmacy, a pharmacy in northeast Tennessee designed a questionnaire to survey patient motivation for traveling long distances to fill their prescriptions for BUP, rather than buprenorphine/naloxone (BNx, combo-product), and to document their satisfaction with treatment with the mono-product.
Buprenorphine Monoproduct for Buprenorphine/Naloxone Tolerability Problems: Navigating Stigma for Patient-centered Addiction Care without Guideline Support.
J Addict Med
November 2023
Substance Use Disorder Treatment Program, Shawnee Health Services and Development Corporation, Carbondale, IL .
The Naloxone Component of Buprenorphine/Naloxone: Discouraging Misuse, but at What Cost?
J Addict Med
February 2023
From the Fora Health Treatment and Recovery, Portland, OR (JG); Fora Health Treatment and Recovery, Portland, OR (JH); Downtown LA Substance Use Disorder Clinic, VA Greater Los Angeles Healthcare System, Los Angeles, CA (DL); Central City Concern, Portland, OR (AR); and Oregon Health and Science University, Portland, OR (CB).
Because opioid overdose deaths in the United States continue to rise, it is critical to increase patient access to buprenorphine, which treats opioid use disorder and reduces mortality. An underrecognized barrier to buprenorphine treatment (both for maintenance and treatment of acute withdrawal) is limited access to buprenorphine monoproduct. In the United States, buprenorphine is primarily prescribed as a combination product also containing naloxone, added to reduce the potential for misuse.
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