Alternative to ‘revolving door’ of opioid detox and relapse

In a first-ever randomized trial, patients at a short-term inpatient program began long-term outpatient treatment with buprenorphine before discharge, with better outcomes than detox patients.

Three out of four people who complete an inpatient opioid withdrawal management program — commonly known as “detox” — relapse within a month, leading to a “revolving door” effect. Few successfully transition from the inpatient setting to long-term treatment with proven medications such as buprenorphine, methadone, or naltrexone to prevent overdose.

But patients who start long-term buprenorphine treatment at a detox program, instead of going through detox and getting a referral for such treatment at discharge, are less likely to use opioids illicitly over the following six months, and more likely to keep up treatment, according to a first-of-its-kind study led by a Boston University School of Public Health (BUSPH) researcher and published in the journal Addiction.

Full story at Science Daily

Use Of Buprenorphine To Treat Opioid Addiction Proliferates In California

Buprenorphine, a relative newcomer in the treatment of opioid addiction, is growing in popularity among California doctors as regulatory changes, physician training and other initiatives make the medication more widely accessible.

The rate of Medi-Cal enrollees who received buprenorphine nearly quadrupled from the end of 2014 to the third quarter of 2018, according to data released by Medi-Cal, the state’s Medicaid program. The rate for methadone — an older and more commonly used drug — was almost unchanged from the end of 2014 through the last quarter of 2017, the most recent period for which data are available.

Buprenorphine and methadone are both opioids. Both reduce cravings for heroin and synthetic opioids while minimizing withdrawal symptoms. But buprenorphine is less potent and less likely to result in fatal overdoses than methadone. California doctors have more flexibility in prescribing it than with methadone or naltrexone, another medication used to treat addiction.

Full story at Kaiser Health News

Monthly buprenorphine injections effective for opioid use disorders

A newly published study suggests the long-acting buprenorphine formulation BUP-XR is more effective than placebo in helping patients struggling with addiction to opioids. BUP-XR is a monthly extended-release injection.

Daily dose buprenorphine was approved by the Food and Drug Administration (FDA) in 2002 and has proven to be effective in the treatment of opioid use disorders (OUD). However, daily doses require patients to recommit to taking medication every day and can result in cravings near the end of the 24-hour cycle. Although the National Institute on Drug Abuse (NIDA) did not fund this current study, it did support the development of buprenorphine as a treatment for OUD. NIDA’s support also contributed to the development and approval of another long-acting buprenorphine formulation — a six-month subcutaneous implant for some patients who have stabilized on daily dosing (Probuphine®).

Full story at drugabuse.org

Children’s Accidental Exposure to Buprenorphine on the Rise

Children’s accidental exposure to the opioid addiction medication buprenorphine is increasing, according to new data from U.S. poison control centers.

Between 2007 and 2016, poison control centers received 11,275 calls about children’s exposure to buprenorphine, CNN reports. Eighty-six percent of exposures were in children younger than 6, and 89 percent of the exposures were unintentional. Buprenorphine can dangerously slow young children’s breathing. Almost one-quarter of the children under 6 who are exposed spend time in intensive care, the researchers noted.

Full story at drugabuse.org

Methadone and buprenorphine reduce risk of death after opioid overdose

A National Institutes of Health-funded study found that treatment of opioid use disorder with either methadone or buprenorphine following a nonfatal opioid overdose is associated with significant reductions in opioid related mortality. The research, published today in the Annals of Internal Medicine, was co-funded by the National Institute on Drug Abuse (NIDA) and the National Center for Advancing Translational Sciences, both parts of NIH.

Study authors analyzed data from 17,568 adults in Massachusetts who survived an opioid overdose between 2012 and 2014. Compared to those not receiving medication assisted treatment, opioid overdose deaths decreased by 59 percent for those receiving methadone and 38 percent for those receiving buprenorphine over the 12 month follow-up period. The authors were unable to draw conclusions about the impact of naltrexone due to small sample size, noting that further work is needed with larger samples. Buprenorphine, methadone, and naltrexone are three FDA-approved medications used to treat opioid use disorder (OUD).

Full story at drugabuse.org