Counseling Points - September 2007 - (Page 16)

Summary For many years, the need for long-term inpatient treatment for recovery from opioid addiction, and the high cost of such treatment, severely limited the number of patients who could enter a recovery program. The recent advent of office-based opioid treatment with buprenorphine has, for the first time, allowed for large numbers of opioid-addicted patients to achieve success in overcoming their dependence and to do so as outpatients. DATA 2000 has made treatment in the privacy of a doctor’s office available, and amendments to the act have increased the number of patients to 100 that an individual physician certified for 1 year can treat. These changes mean that many patients now suffering from the effects of opioid addiction may access appropriate medical care for their disease and that the medical community has vastly expanded its potential reach in helping such patients recover from opioid addiction. References Agency for Healthcare Research and Quality [AHRQ]. The Guide to Clinical Preventive Services. Recommendations of the US Preventive Services Task Force. Washington, DC: Department of Health and Human Services [DHHS]; 2006. Amass L, Kamien JB, Mikulich SK. Efficacy of daily and alternate-day dosing regimens with the combination buprenorphine-naloxone tablet. Drug Alcohol Depend. 2000;58:143-152. Amass L, Kamien JB, Mikulich SK. Thrice-weekly supervised dosing with the combination buprenorphine-naloxone tablet is preferred to daily supervised dosing by opioid-dependent humans. Drug Alcohol Depend. 2001;61:173-181. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, (4th ed., text revision). Arlington, VA: American Psychiatric Association; 2000. Bickel WK, Amass L. Buprenorphine treatment of opioid dependence: A review. Exper Clin Psychopharmacol. 1995;3:477-489. Chawarski MC, Schottenfeld RS, O’Connor PG, Pakes J. Plasma concentrations of buprenorphine 24 to 72 hours after dosing. Drug Alcohol Depend. 1999;55:157-163. Collins ED, Kleber HD, Whittington RA, et al. Anesthesia-assisted vs buprenorphine- or clonidine-assisted heroin detoxification and naltrexone induction: a randomized trial. JAMA. 2005;294:903913. Comer SD, Collins ED. Self-administration of intravenous buprenorphine and the buprenorphine/naloxone combination by recently detoxified heroin abusers. J Pharmacol Exp Ther. 2002;303(2):695703. Cowan A. Buprenorphine. New pharmacological aspects. Int J Clin Pract. 2003;113(suppl):3-8. Crawley JN, Laberty RN, Roth RH. Clonidine reversal of increased norepinephrine metabolite levels during morphine withdrawal. Eur J Pharmaco.l 1979;57:247-255. Doweiko HE. Concepts of Chemical Dependency. Belmont, Ca: Thomson Brooks/Cole; 2006. Fornili K. Substance Abuse Tool Box. Richman, Va: Virginia Office of Substance Abuse Services; 2004. Greenwald MK, Schuh KJ, Stine SM. Transferring methadone-maintained outpatients to the buprenorphine sublingual tablet: a preliminary study. Am J Addiction. 2003;12(4):365-374. Jaffe JH. Drug addiction and drug abuse. In: Gilman AG, Rall TW, Nies AS, et al, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 8th ed. New York, NY: Pergamon Press; 1990:485-521. Johnson RE, Strain EC, Amass L. Buprenorphine: How to use it right. Drug and Alcohol Depend.2003;70(suppl.):S59-S77. Kobayashi K, Yamamoto T, Chiba K, et al. Human buprenorphine Ndealkylation is catabolised by cytochrome P4503A4. Drug Metab Dispos. 1998;26(8):818-821. Pasternak GW.. Pharmacological mechanisms of opioid analgesics. Clin Neuropharmacol 1993;16(1). Reisine T, Pasternak GW. Opioid analgesics and antagonists. In: Hardman JG, Gilman AG, Limbird LE, eds. Goodman and Gilman’s The Pharmacological Basis of Therapeutics, 9th ed. New York, NY: McGraw-Hill;1996:521-555. Suboxone® Full U.S. Prescribing Information. Accessed 9/05/07 at www.suboxone.com/pdfs/suboxonepi.pdf. Substance Abuse and Mental Health Services Administration Office of Applied Studies. Results from the 2005 National Survey on Drug Use and Health: National Findings. Washington, DC: US Department of Health and Human Services; 2005. Substance Abuse and Mental Health Services Administration. A Guide to Substance Abuse Services for Primary Care Clinicians. Treatment Improvement Protocol (TIP) Series 24. Washington, DC: US Department of Health and Human Services; 1997. Substance Abuse and Mental Health Services Administration. Clinical Guidelines for the Use of Buprenorphine in the Treatment of Opioid Addiction. Treatment Improvement Protocol (TIP) Series 40. Washington, DC: US Department of Health and Human Services; 2004. Substance Abuse and Mental Health Services Administration Substance Abuse Treatment for Persons with Co-occuring Disorders. Treatment Improvement Protocol (TIP) Series 42. Washington, DC: US Department of Health and Human Services; 2005. Substance Abuse and Mental Health Services Administration . Medication Assisted Treatment For Opioid Addiction in Opioid Treatment Programs. A Treatment Improvement Protocol (TIP), Series 43. Washington, DC: US Department of Health and Human Services; 2005. Substance Abuse and Mental Health Services Administration . Detoxification and Substance Abuse Treatment. Treatment Improvement Protocol (TIP) Series 45. Washington, DC: US Department of Health and Human Services; 2006. Walsh SL, Preston KL, Stitzer ML et al. Clinical pharmacology of buprenorphine: Ceiling effects at high doses. Clin Pharmacol Ther. 1994;55(5):569-580. Way WL, Fields HL, Way EL. Opioid analgesics and antagonists. In: Katzung B, ed. Basic and Clinical Pharmacology, 7th ed. Stamford, Ct:Appleton & Lange;1998:496-515. 16 COUNSELING POINTS™ http://www.suboxone.com/pdfs/suboxonepi.pdf

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Welcome Office-Based Medication-Assisted Treatment of Opioid Dependence Summary Continuing Education Posttest Postest Answer and Program Evaluation Form

Counseling Points - September 2007

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