Methadone versus buprenorphine for the treatment of opioid abuse in pregnancy: science and stigma.

Buprenorphine Research (PubMed) - Sat, 07/11/2015 - 6:00am

Methadone versus buprenorphine for the treatment of opioid abuse in pregnancy: science and stigma.

Am J Drug Alcohol Abuse. 2015 Jul 8;:1-3

Authors: Holbrook AM

Abstract
The past decade has seen an increase in rates of opioid abuse during pregnancy. This clinical challenge has been met with debate regarding whether or not illicit and prescription opioid-dependent individuals require different treatment approaches; whether detoxification is preferable to maintenance; and the efficacy of methadone versus buprenorphine as treatment options during pregnancy. The clinical recommendations resulting from these discussions are frequently influenced by the comparative stigma attached to heroin abuse and methadone maintenance versus prescription opioid abuse and maintenance treatment with buprenorphine. While some studies have suggested that a subset of individuals who abuse prescription opioids may have different characteristics than heroin users, there is currently no evidence to suggest that buprenorphine is better suited to treatment of prescription opioid abuse than methadone. Similarly, despite its perennial popularity, there is no evidence to recommend detoxification as an efficacious approach to treatment of opioid dependence during pregnancy. While increased access to treatment is important, particularly in rural areas, there are multiple medical and psychosocial reasons to recommend comprehensive substance abuse treatment for pregnant women suffering from substance use disorders rather than office-based provision of maintenance medication. Both methadone and buprenorphine are important treatment options for opioid abuse during pregnancy. Methadone may still remain the preferred treatment choice for some women who require higher doses for stabilization, have a higher risk of treatment discontinuation, or who have had unsuccessful treatment attempts with buprenorphine. As treatment providers, we should advocate to expand available treatment options for pregnant women in all States.

PMID: 26154531 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Buprenorphine-elicited alteration of adenylate cyclase activity in human embryonic kidney 293 cells coexpressing κ-, μ-opioid and nociceptin receptors.

Buprenorphine Research (PubMed) - Sat, 07/11/2015 - 6:00am

Buprenorphine-elicited alteration of adenylate cyclase activity in human embryonic kidney 293 cells coexpressing κ-, μ-opioid and nociceptin receptors.

J Cell Mol Med. 2015 Jul 8;

Authors: Wang PC, Ho IK, Lee CW

Abstract
Buprenorphine, a maintenance drug for heroin addicts, exerts its pharmacological function via κ- (KOP), μ-opioid (MOP) and nociceptin/opioid receptor-like 1 (NOP) receptors. Previously, we investigated its effects in an in vitro model expressing human MOP and NOP receptors individually or simultaneously (MOP, NOP, and MOP+NOP) in human embryonic kidney 293 cells. Here, we expanded this cell model by expressing human KOP, MOP and NOP receptors individually or simultaneously (KOP, KOP+MOP, KOP+NOP and KOP+MOP+NOP). Radioligand binding with tritium-labelled diprenorphine confirmed the expression of KOP receptors. Immunoblotting and immunocytochemistry indicated that the expressed KOP, MOP and NOP receptors are N-linked glycoproteins and colocalized in cytoplasmic compartments. Acute application of the opioid receptor agonists- U-69593, DAMGO and nociceptin- inhibited adenylate cyclase (AC) activity in cells expressing KOP, MOP and NOP receptors respectively. Buprenorphine, when applied acutely, inhibited AC activity to ~90% in cells expressing KOP+MOP+NOP receptors. Chronic exposure to buprenorphine induced concentration-dependent AC superactivation in cells expressing KOP+NOP receptors, and the level of this superactivation was even higher in KOP+MOP+NOP-expressing cells. Our study demonstrated that MOP receptor could enhance AC regulation in the presence of coexpressed KOP and NOP receptors, and NOP receptor is essential for concentration-dependent AC superactivation elicited by chronic buprenorphine exposure.

PMID: 26153065 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Response.

Buprenorphine Research (PubMed) - Sat, 07/11/2015 - 6:00am
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Response.

Can Fam Physician. 2014 Nov;60(11):986

Authors: Koren G

PMID: 25392437 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Not antagonist treatment.

Buprenorphine Research (PubMed) - Sat, 07/11/2015 - 6:00am
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Not antagonist treatment.

Can Fam Physician. 2014 Nov;60(11):986

Authors: Newman R, Gevertz S

PMID: 25392436 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

What DO I do with those extra meds? A few simple steps.

Drug and Alcohol News (JoinTogether.com) - Wed, 07/08/2015 - 4:13pm

Teen medicine abuse is an epidemic. That’s not our declaration; it’s that of the CDC, who doesn’t throw the term “epidemic” around loosely.  It’s no secret that this behavior is a problem (and a devastating one); what is sometimes confusing, though, is what you can do in your own home to prevent the behavior and protect your family.

At the Partnership, we know that kids and adults who intend to abuse are not only accessing medicine from their own homes, but they seek it at the homes of their friends’ parents; their grandparents; and others. Safeguarding and properly disposing of the medicine you keep at home is an action that everyone should take – regardless of whether or not you believe your teen or family is at risk.

So, how do you deal with those unwanted, expired or unused medicines in your home? Here are some simple steps to help clear up the confusion.

  1. The best and safest way to dispose of unwanted medicine is by finding a take-back location near you. The American Medicine Chest Challenge features a national directory of permanent prescription collection sites in every state across the country, so you can learn where to take your meds year round. The DEA also hosts national take-back days a few times per year. Either of these options are ideal ways of disposing of your medicine.
  2. If you can’t get to a take-back location and must dispose of your meds at home, it is best to crush them up and mix them with an undesirable substance – like coffee grounds or kitty litter – and throw the mixture in the trash. This makes pills less appealing and less recognizable to anyone who can see your trash – including your teens. Note: flushing your medicine is not advised and is dangerous, as it contaminates water and causes an environmental hazard.

Of course, many people have medicine at home that they are actively using, or need to keep at home for future use. If this is the case, be vigilant about counting your pills and safeguarding this medicine.

Finally, but perhaps most importantly, talk to your kids and family about the dangers of abusing medicine. For more information on how you can help #EndMedicineAbuse at home and in your community, visit our Medicine Abuse Project website.

The post What DO I do with those extra meds? A few simple steps. appeared first on Partnership for Drug-Free Kids.

Categories: Bup Feeds

Endovascular treatment of infected brachial pseudoaneurysm in an intravenous drug abuser: a case report.

Buprenorphine Research (PubMed) - Mon, 07/06/2015 - 6:30am

Endovascular treatment of infected brachial pseudoaneurysm in an intravenous drug abuser: a case report.

Ann Vasc Surg. 2015 Jul 1;

Authors: Raluca B, Georg Y, Ramlugun D, Martinot M, Camin A, Matysiak L, Kretz B

Abstract
We report the case of a 36-year old male, admitted in the emergency room with a non ruptured brachial pseudoaneurysm after Buprenorphine injection, with no signs of distal acute ischemia. After endovascular treatment with a nitinol covered stent associated with adapted antibiotherapy and 35 days of hospitalizations, the patient was discharged with good short results but stent need to be removed at 6 months for thrombosis and partial exposure through the wound.

PMID: 26142880 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Opioids for field procedures in equine practice.

Buprenorphine Research (PubMed) - Sat, 07/04/2015 - 7:30am
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Opioids for field procedures in equine practice.

Vet Rec. 2014 Dec 20-27;175(24):621-2

Authors: Schauvliege S

PMID: 25523998 [PubMed - indexed for MEDLINE]

Categories: Bup Feeds

Pronociceptive and Antinociceptive Effects of Buprenorphine in the Spinal Cord Dorsal Horn Cover a Dose Range of Four Orders of Magnitude.

Buprenorphine Research (PubMed) - Fri, 07/03/2015 - 7:30am

Pronociceptive and Antinociceptive Effects of Buprenorphine in the Spinal Cord Dorsal Horn Cover a Dose Range of Four Orders of Magnitude.

J Neurosci. 2015 Jul 1;35(26):9580-9594

Authors: Gerhold KJ, Drdla-Schutting R, Honsek SD, Forsthuber L, Sandkühler J

Abstract
Due to its distinct pharmacological profile and lower incidence of adverse events compared with other opioids, buprenorphine is considered a safe option for pain and substitution therapy. However, despite its wide clinical use, little is known about the synaptic effects of buprenorphine in nociceptive pathways. Here, we demonstrate dose-dependent, bimodal effects of buprenorphine on transmission at C-fiber synapses in rat spinal cord dorsal horn in vivo. At an analgesically active dose of 1500 μg·kg(-1), buprenorphine reduced the strength of spinal C-fiber synapses. This depression required activation of spinal opioid receptors, putatively μ1-opioid receptors, as indicated by its sensitivity to spinal naloxone and to the selective μ1-opioid receptor antagonist naloxonazine. In contrast, a 15,000-fold lower dose of buprenorphine (0.1 μg·kg(-1)), which caused thermal and mechanical hyperalgesia in behaving animals, induced an enhancement of transmission at spinal C-fiber synapses. The ultra-low-dose buprenorphine-induced synaptic facilitation was mediated by supraspinal naloxonazine-insensitive, but CTOP-sensitive μ-opioid receptors, descending serotonergic pathways, and activation of spinal glial cells. Selective inhibition of spinal 5-hydroxytryptamine-2 receptors (5-HT2Rs), putatively located on spinal astrocytes, abolished both the induction of synaptic facilitation and the hyperalgesia elicited by ultra-low-dose buprenorphine. Our study revealed that buprenorphine mediates its modulatory effects on transmission at spinal C-fiber synapses by dose dependently acting on distinct μ-opioid receptor subtypes located at different levels of the neuraxis.

PMID: 26134641 [PubMed - as supplied by publisher]

Categories: Bup Feeds

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