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Results sorted by updated date (oldest first)
Posted 3/22/2022 (updated 3/27/2024)
The purpose of this document is to provide detailed guidelines of the Nurse Care Manager Model of Office Based Addiction Treatment program for management of substance use disorders, with particular emphasis on treatment of opioid use disorder with buprenorphine (alone and in combination with naloxone) and naltrexone (oral and extended-release injectable formulations).
Posted 10/5/2021 (updated 4/3/2024)
This webinar focused on the crucial role of the emergency department (ED) in recognizing and treating opioid use disorder (OUD) patients with evidence-based medications for addiction treatment. Gail D’Onofrio, MD, discussed her pioneering work in creating the evidence for initiating ED buprenorphine treatment with ED patients presenting with opioid use disorder. Overall, the opioid epidemic intertwined with the COVID-19 pandemic has greatly escalated the need to mitigate the morbidity and mortality associated with the rising rate of fentanyl use. Data supporting the use of buprenorphine in the ED setting as well as the consequences of not initiating treatment will be discussed. While the use of ED prescribed buprenorphine has increased, universal adoption has lagged. Barriers to implementation of ED buprenorphine were discussed as well as strategies to overcome these challenges. Components of successful integration of an ED program with community partnerships was outlined. Current research by emergency physicians regarding innovative strategies such as high-dose buprenorphine inductions and use of extended release 7-day formulation of buprenorphine will be discussed. Initiation buprenorphine effectively, reduces withdrawal symptoms, improves adherence to treatment, and saves lives.
Posted 2/18/2021 (updated 4/4/2024)
Opioid use disorder (OUD), a chronic disease, is a major public health problem. Despite availability of effective treatment, too few people receive it and treatment retention is low. Understanding barriers and facilitators of treatment access and retention is needed to improve outcomes for people with OUD.
In this study we sought to assess 3-month outcomes from a patient-centered practice that included MAT with buprenorphine or naltrexone plus the option to participate in psychosocial treatments. The psychosocial treatments included case management, psychotherapy, peer recovery groups such as Narcotics Anonymous or Smart Recovery, or peer support through a local harm reduction program.
Posted 5/26/2021 (updated 4/10/2024)
Opioid dependence is a chronic relapsing disorder with considerable individual and global public health burden. The current standard of care for opioid dependence includes treatment with methadone or sublingual (SL) buprenorphine or buprenorphine-naloxone (hereafter, buprenorphine), combined with psychosocial and behavioral support. Both medications are associated with reductions in mortality, illicit opioid use, bloodborne viral infections, and criminal behavior as well as better cost-effectiveness than no treatment or psychosocial treatment alone. Buprenorphine is a partial μ-opioid receptor agonist, enabling office-based treatment for nonsupervised or take-home use of the medication. However, SL formulations of buprenorphine are prone to nonmedical use (eg, injecting, diversion), prompting models of care, particularly in the early phases of treatment, requiring regular attendance at clinics or pharmacies for administration of doses.