buprenorphine or methadone associated with reductions in overdose *

Here’s the conclusion of an interesting new paper: Treatment with buprenorphine or methadone was associated with reductions in overdose and serious opioid-related acute care use compared with other treatments. Strategies to address the underuse of MOUD are needed. Seems pretty straightforward, right? Buprenorphine and methadone protect patients from OD. But, I added an asterisk. Why? … Continue reading buprenorphine or methadone associated with reductions in overdose *

Research Article Review: Buprenorphine for Severe Suicidal Ideation

This post will consist of an overview of one particular research report, and some of my thoughts about it.  Here is the citation of the paper I’ll be discussing: Yovell, Y., Bar, G., Mashiah, M., Baruch, Y., Briskman, I., Asherov, J., Lotan, A., Rigbi, A. & Panksepp, J.  (2016).  Ultra-Low-Dose Buprenorphine as a Time-Limited Treatment … Continue reading Research Article Review: Buprenorphine for Severe Suicidal Ideation

Initiating buprenorphine treatment during short‐term inpatient ‘detoxification’

A new study on initiation of buprenorphine maintenance was just published. The press release describes the intervention as an alternative to “revolving door” detox and relapse cycles: “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 … Continue reading Initiating buprenorphine treatment during short‐term inpatient ‘detoxification’

Low barrier buprenorphine treatment for persons experiencing homelessness and injecting heroin

There was a lot of enthusiasm about this study on twitter recently. It appears to be based on this program highlighted in the NY Times last year. . . . city health workers are taking to the streets to find homeless people with opioid use disorder and offering them buprenorphine prescriptions on the spot. The … Continue reading Low barrier buprenorphine treatment for persons experiencing homelessness and injecting heroin

Sentences to ponder

From Reconsidering the Usefulness of Adding Naloxone to Buprenorphine: If information circulating in the recreational drug-using community is in reality more accurate than the information coming from the medical community, it can only be a matter of time before that hard-won trust is eroded. Blazes, C.K., & Morrow, J. (2020). Reconsidering the Usefulness of Adding … Continue reading Sentences to ponder

Study of Long-acting buprenorphine published–17% respond

A new JAMA study concludes, “Long-acting buprenorphine depot formulations appear to be efficacious for treatment of opioid use disorder.” Keep reading. They compared the effectiveness of sublingual (oral) and long-acting injections of buprenorphine to see if the long-acting injections are as effective as the sublingual version. The study was 24 weeks. That’s better than we … Continue reading Study of Long-acting buprenorphine published–17% respond

Addiction treatment’s uncertain future

Programs closing This story about the impact of COVID on the treatment industry grabbed my attention: At the beginning of 2020, addiction treatment was a solid, growing industry, with 15,000 providers, $42 billion yearly revenue, and a projected 5.2% annual growth. Then Covid-19 hit. By the summer, the industry had lost $4 billion in revenue, and about … Continue reading Addiction treatment’s uncertain future

Medical mistrust as a two-way street

Austin posted yesterday about Jon Soske’s piece selecting an addiction/recovery element to keep, one to drop, and one to modify. The element Jon chose to modify is “medical mistrust.” A couple of sentences exploring this concept really grabbed me. The pandemic made even more visible the intensity of suspicion regarding health institutions and the medical … Continue reading Medical mistrust as a two-way street

Another buprenorphine retention finding

There has been a lot of discussion about the use of buprenorphine to treat addiction and prevent overdose. I’ve pointed out that weak retention rates weaken this rationale. One common response is that the treatment system and recovering community reinforce stigma associated with maintenance medications and undermine outcomes, including retention. This makes retention findings from other … Continue reading Another buprenorphine retention finding

Follow up – Responses to charges against Invidior

So . . . a week and a half ago, Indivior, the manufacturer of Suboxone, was charged with conspiracy, health care fraud, mail fraud and wire fraud. Prosecutors said: Indivior misled doctors and government health programs into believing that the drug, Suboxone Film, was safer and less likely to be abused than rivals, the Justice … Continue reading Follow up – Responses to charges against Invidior