When discussing the goal of abstinence for opioid use disorder, it sometimes comes up that it's much safer to stay in medication assisted treatment (most often methadone or buprenorphine) than to detox. I agree, but I would never advise a patient just to detox. Detox is a procedure, not a treatment as such. If all … Continue reading Reducing the risks of opioid detox
In the Washington Post, Harold Pollack interviewed Peter Friedmann about buprenorphine and the NY Times series on buprenorphine. We're fortunate that that they share their premises. HP: Buprenorphine provides a “substitution therapy” for people with opiate disorders. PF: Correct. For many years, opiate addiction was considered an incurable illness. It was Dole and Nyswander in New York who proposed … Continue reading Two more defenses of Suboxone
A study out of Australia looks at death rates among opioid addicts receiving opioid substitution treatment (OST, for short. It's methadone.) in New South Wales between 1985-2005. It's a HUGE sample--43,789 people. If fact, the paper says: This cohort is likely to represent the majority of opioid dependent people in that State during this period, … Continue reading Quality of life and death
The following abstract popped up today. The purpose of the study was to look at factors associated with completion of the 6 month, primary care based program. What struck me was the completion rate--35.7%. For all the crowing about ORT, this seems really low. (And, they said this completion rate is consistent with prior studies.) … Continue reading Buprenorphine compliance rates
A new study of buprenorphine implants find that implants work as well as oral dosing and outperform placebo. What does that mean? If I'm reading it correctly, it means that the average subject receiving the implant tested positive for opioids 68.8% of the time compared to 86.6% for the placebo subjects. (If I'm misreading it, … Continue reading “It works!”, Ctd
Ian McLoone directs us to another study (the 4th in a row) finding that buprenorphine patients receive no benefit from added behavioral treatments. Where does this leave us? We've seen criticism of the devolution of methadone maintenance (MMT) into dosing clinics with calls for a new recovery orientation to MMT and a return to methadone being … Continue reading Buprenorphine + therapy = ?
I would have thought this was a softball in support of buprenorphine. But, no: Among subjects with prior criminal charges, initiation of office-based buprenorphine treatment did not appear to have a significant impact on subsequent criminal charges. The paper gets a little says that this lack of effect includes drug charges. I'm no fan of … Continue reading Criminal charges before and after initiation of buprenorphine maintenance