A Guide to Expanding the Use of Buprenorphine Beyond Standard Initiations for Opioid Use Disorder

This article briefly discusses the opioid epidemic and the diagnosis and treatment of opioid use disorder (OUD). We then describe the basic and complex pharmacologic propertie s of buprenorphine, linking these properties to their clinical implications. We guide readers through the process of initiating buprenorphine in patients using full agonist opioids. As there is no single recommended approach for buprenorphine initiation, we discuss the details, advantages, and disad vantages of the standard, low-dose, bridging-strategy, and naloxone-facilitated initiation techniques. We consider the pharmacology of, and evidence base for, buprenorphine in the treatment of pain, in both OUD and non-OUD patients. Throughout, we address the use of buprenorphine in children and ado lescent patients, and we finish with considerations related to the settings of pregnancy and breastfeeding.
Source: Drugs in R&D - Category: Drugs & Pharmacology Source Type: research