Article Commentary: Demystifying Buprenorphine Misuse: Has Fear of Diversion Gotten in the Way of Addressing the Opioid Crisis?

Substance Abuse - Tập 40 Số 2 - Trang 148-153 - 2019
Molly Doernberg1, Noa Krawczyk2,3, Deborah Agus2,3, Michael Fingerhood3,4
1Yale University School of Public Health, New Haven, Connecticut, USA
2Behavioral Health Leadership Institute, Baltimore, Maryland, USA;
3Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
4Johns Hopkins School of Medicine, Baltimore, Maryland, USA

Tóm tắt

Buprenorphine is considered one of the most effective treatments for opioid use disorder and significantly reduces risk of overdose death. However, concerns about its diversion and misuse have often taken center stage in public discourse and in the design of practices and policies regarding its use. This has been to the detriment of many vulnerable patient populations, especially those involved in the criminal justice system. Policies that restrict access to buprenorphine in criminal justice and other settings due to concerns of diversion do not accurately reflect the relative risks and safety profile associated with it, creating unnecessary barriers that drive an illicit market of this much-needed medication. Although proper regulation of all controlled medications should be a priority, in most instances the benefits of buprenorphine highly outweigh its risks. In the midst of a national crisis, efforts should be focused on expanding, and not restricting, access to this lifesaving treatment.

Từ khóa


Tài liệu tham khảo

Substance Abuse and Mental Health Services Administration, 2017, Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health

National Institute on Drug Abuse. Overdose Death Rates. National Institute on Drug Abuse. https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates. Published August 9, 2018. Accessed October 8, 2018.

Centers for Disease Control and Prevention. Identifying increases in opioid overdoses. Centers for Disease Control and Prevention. https://www.cdc.gov/vitalsigns/opioid-overdoses/index.html. Published March 16, 2018. Accessed July 4, 2018.

10.1056/NEJMp1402780

10.1124/jpet.102.038141

10.1097/ADM.0000000000000045

10.2105/AJPH.2012.301049

10.1136/bmj.j1550

10.2174/1874473711104010028

Substance Abuse and Mental Health Services Administration. Buprenorphine Waiver Management. Substance Use and Mental Health Services Administration. https://www.samhsa.gov/programs-campaigns/medication-assisted-treatment/training-materials-resources/buprenorphine-waiver. Published June 22, 2015. Accessed July 4, 2018.

10.2105/AJPH.2015.302664

Crawford C, Am Acad Fam Phys

DeFlavio, 2015, Rural Remote Health., 15, 3019

10.1007/s11606-008-0686-x

Sontag D, 2018, The New York Times

Macy B, 2018, The New York Times

Walsh SL, 1995, J Pharmacol Exp Ther, 274, 361

10.1038/clpt.1994.71

Bliley T. Drug Addiction Treatment Act of 2000. 2000. https://www.congress.gov/bill/106th-congress/house-bill/2634. Accessed July 4, 2018.

10.1001/jamainternmed.2013.9059

American Society of Addiction Medicine, 2013, Implications for opioid addiction treatment

10.1016/j.jsat.2017.04.005

Bronson J, 2017, Drug use, dependence, and abuse among state prisoners and jail inmates, 2007-2009

10.1177/1078345816685311

10.7326/0003-4819-159-9-201311050-00005

10.1056/NEJMsa064115

10.1111/j.1360-0443.2010.02990.x

10.1080/08897077.2011.611460

10.17265/2159-5313/2016.09.003

10.1377/hlthaff.2017.0890

Deehan M, 2018, WGBH

Kilmer M, 2018, Washington Post

10.1016/j.drugalcdep.2009.06.015

Schwartzapfel B, 2018, The Marshall Project

10.1016/j.jsat.2012.10.004

10.1007/s11920-013-0414-z

Green TC, 2018, J Am Med Assoc, 75, 405

Office of National Drug Control Policy, 2016, Convening: medication assisted treatment for justice-involved populations

Pecoraro A, 2011, F1000 Med Rep, 3, 1

Tomasino V, 2001, Mt Sinai J Med, 68, 14

10.1016/j.jsat.2016.08.002

10.1016/j.drugalcdep.2014.06.005

10.1097/ADM.0b013e3182034e31

10.1016/j.addbeh.2013.08.008

10.1016/j.jsat.2017.04.017

10.3109/10550490903077820

10.1016/j.jsat.2010.03.014

10.1016/j.jsat.2014.07.015

10.1097/ADM.0b013e31829727b2

10.1016/j.jsat.2010.04.001

10.1016/j.jsat.2015.04.010

10.1001/archinternmed.2010.541

Center for Behavioral Health Statistics and Quality., 2013, Emergency department visits involving buprenorphine

10.1016/j.drugalcdep.2015.08.007

10.1111/j.1526-4637.2010.00877.x

10.1016/j.jemermed.2012.11.104

10.1111/j.1521-0391.2012.00335.x

10.1517/14656566.2014.955469

10.1186/s12954-015-0037-2

10.5055/jom.2007.0018

10.1016/j.drugalcdep.2012.05.025

10.1016/j.drugalcdep.2015.12.021

10.1057/jphp.2014.54

10.1300/J069v25n03_11

10.1377/hlthaff.2011.1392

10.1016/0376-8716(96)01273-2

10.1016/j.jsat.2013.11.002

10.1086/508183

10.1377/hlthaff.2015.1496

10.1016/j.drugalcdep.2018.01.015

10.1016/j.jsat.2011.04.008

American Society of Addiction Medicine, Nurse practitioners and physician assistants prescribing buprenorphine

Andrilla CHA, J Rural Health, 108

Andrilla CHA, 2018, Med Care Res Rev, 107755871879307

Williams T, 2018, The New York Times

Thông tin
Thông tin xuất bản

Substance Abuse

Tập 40 Số 2

148-153

Thông tin tác giả