A major healthcare provider recently announced that it would begin requiring preauthorization for prescriptions of the buprenorphine-based addiction medications Suboxone and Subutex, a move that has raised concern among physicians and patient-advocacy groups about erecting new barriers to treatment. (Source: Alcohol, Tobacco and Other Drugs News) MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.
Related Articles Narrative review: buprenorphine for opioid-dependent patients in office practice. Ann Intern Med. 2008 May 6;148(9):662-70 Authors: Sullivan LE, Fiellin DA The profile of opioid dependence in the United States is changing. Abuse of prescription opioids is more common than that of illicit opioids: Recent data indicate that approximately 1.6 million persons abuse or are dependent on prescription opioids, whereas 323,000 abuse or are dependent on heroin. Despite this prevalence, nearly 80% of opioid-dependent persons remain untreated. One option for expanding treatment is the use of buprenorphine and the buprenorphine-naloxone combination. Buprenorphine is a partial opioid agonist that can be prescribed by trained physicians and dispensed at pharmacies. This article addresses the clinical presentation of a patient with opioid dependence and describes the relatively new practice of office-based treatment with buprenorphine-naloxone. The different components of treatment; the role of the physician who provides this treatment; and the logistics of treating this growing, multifaceted patient population are also examined. PMID: 18458279 [PubMed - in process] (Source: Annals of Internal Medicine)
This narrative review discusses the use of buprenorphine plus naloxone in treatment of opioid dependence in the primary-care setting. While areas of the review discusses specific US practice, it includes much information that will be more generally relevant. The authors present an example patient, a woman aged 35 who has become dependent on oxycodone originally prescribed for pain control following a wrist fracture. They discuss the symptoms of opioid dependence in such patients, and potential management options, concentrating on the combination of buprenorphine plus naloxone as an option that can be used in primary care. (Source: NeLM Headline News)
(Source: PharmacoEconomics and Outcomes News)
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Related Articles [Drugs for postoperative analgesia: routine and new aspects : Part 2: Opioids, ketamine and gabapentinoids.] Anaesthesist. 2008 May;57(5):491-8 Authors: Jage J, Laufenberg-Feldmann R, Heid F In part 1 of this review, perioperative aspects of the use of non-opioids (acetaminophene, dipyrone, traditional NSAR, coxibs) were discussed. In part 2 the perioperative aspects of opioids (weak opioids: tramadol, tilidine with naloxone, strong opioids: morphine, piritramide, oxycodone, hydromorphone, fentanyl, methadone, buprenorphine) and coanalgesics (gabapentinoids; ketamine) will now be presented. The main aim of the review is to describe the use, risks and cost of some substances to facilitate the differential indication. New aspects concerning the use of gabapentinoids and ketamine are discussed. PMID: 18409073 [PubMed - in process] (Source: Der Anaesthesist) MedWorm Sponsored Message: Find out how you can get your message across here by sponsoring this MedWorm news feed.