Cutting the red tape with buprenorphine treatment for opioid use disorder

Tuesday morning. Sarah wakes up at 4 a.m., like every other morning, to go to clinic to get a medicine she cannot function without.  But it’s not as easy as that. She has to take her three small children with her because she is a single parent and has no one else to stay at home with them.  She does this six days a week. This is her life. This is the reality of methadone clinics, and as a family physician, I worry about the impact this is having on the health and well-being of her family. The opioid epidemic is increasingly being recognized as one of the largest health care problems facing our nation, and medication-assisted treatment, like methadone, is often at the forefront of discussion.  While methadone is a highly effective treatment, more attention needs to be paid to the other FDA approved medication for opioid use disorder, buprenorphine. As a dual buprenorphine and methadone provider, I have a unique ability to compare these treatment modalities.  The evidence and my experience is that buprenorphine is superior across the board in ease of use, withdrawal profile, risk of abuse, dangerous side effects and above all, risk of overdose. As a strong partial agonist of the opioid Mu receptor, buprenorphine has a ceiling effect such that there is almost no risk of overdose, even in combination with other opioids.  This is not the case with methadone for opioid addiction, which is reason why it is so highly regulated through specific methadone clinics.  While t...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Meds Pain Management Primary Care Source Type: blogs