Bup Feeds

Recognizing potential buprenorphine medication misuse: product packaging does not degrade with laundering.

Buprenorphine Research (PubMed) - Fri, 03/27/2015 - 6:00am

Recognizing potential buprenorphine medication misuse: product packaging does not degrade with laundering.

Subst Abus. 2015 Mar 26;:0

Authors: Gunderson EW

Abstract
BACKGROUND: Expanded office-based buprenorphine opioid dependence treatment is associated with medication misuse and diversion consequences. Recurrent early refill requests may indicate misuse or diversion, though further research is needed on how to effectively recognize and address the issue in clinical practice. In the current study, patient report of damaged medication from laundering prompted evaluation of laundering on degradation of buprenorphine-containing product packages and contents.
METHODS: Four buprenorphine-product packaging approaches were assessed: three buprenorphine/naloxone placebo demonstration products (Suboxone(→) and Bunavail(→) film in foil wrappers, and Zubsolv(→) tablet in a blister pack), and Rexam-manufactured Screw-Loc(→) closure pill container filled with a chewable aspirin as a surrogate for generic buprenorphine and buprenorphine/naloxone products. Two experimental laundering conditions, wash machine alone (W) and washer/dryer (W+D), were compared to unlaundered control (C) condition. Standard laundering settings were based on patient presentation. Products from the two experimental and control conditions were labeled A, B, or C with counterbalanced assignment prior to visual examination of packaging and contents by the investigator who was blinded to condition.
RESULTS: Packaging and contents remained intact for all products across experimental conditions with only minor cosmetic effects compared to control. The W+D Suboxone film had 1-2mm curling of the wrapper corners. Zubsolv blister packs had slight paper label fading (W+D > W). Bunavail W+D foil had an indentation outlining the inner film. The W+D bottle tablet had a ˜1mm nick on one edge. No other differences were noted. After implementing more structured treatment and reviewing the results with the patient, he endorsed fabricating the laundering story to get additional medication.
CONCLUSIONS: Laundering is an unlikely cause of damaged buprenorphine-containing medication packaged in foil wrappers (Suboxone(→), Bunavail(→)), blister pack (Zubsolv(→)) or prescription pill bottle (generic buprenorphine or buprenorphine/naloxone products). Patient reports of such may indicate medication misuse or diversion.

PMID: 25811238 [PubMed - as supplied by publisher]

Categories: Bup Feeds

UHPLC-MS/MS quantification of buprenorphine, norbuprenorphine, methadone, and glucuronide conjugates in umbilical cord plasma.

Buprenorphine Research (PubMed) - Fri, 03/27/2015 - 6:00am

UHPLC-MS/MS quantification of buprenorphine, norbuprenorphine, methadone, and glucuronide conjugates in umbilical cord plasma.

Biomed Chromatogr. 2015 Mar 22;

Authors: Kyle AR, Carmical J, Shah D, Pryor J, Brown S

Abstract
Opioid use during pregnancy can result in the newborn being physically dependent on the substance, thus experiencing drug withdrawal, termed neonatal abstinence syndrome (NAS). Buprenorphine and methadone are two drugs used to treat opioid withdrawal and are approved for use in pregnancy. Quantification of these compounds in umbilical cord plasma would help assess in utero exposure of neonates in cases of buprenorphine or methadone use during pregnancy. An LC-MS/MS method using solid-phase extraction sample preparation was developed and validated for the simultaneous quantification of methadone, buprenorphine, norbuprenorphine, and glucuronide metabolites in umbilical cord plasma. The average accuracy (percentage error) and precision (relative standard deviation) were <15% for each validated concentration. Our data establishes a 2 week maximum freezer storage window in order to achieve the most accurate cord plasma concentrations of these analytes. Additionally, we found that the umbilical cord tissue analysis was less sensitive compared with analysis with umbilical cord blood plasma, indicating that this may be a more appropriate matrix for determination of buprenorphine and metabolite concentrations. This method was successfully applied to the analysis of cord blood from women with known buprenorphine or methadone use during pregnancy. Copyright © 2015 John Wiley & Sons, Ltd.

PMID: 25808363 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Quantification of morphine, morphine 6-glucuronide, buprenorphine, and the enantiomers of methadone by enantioselective mass spectrometric chromatography in whole blood.

Buprenorphine Research (PubMed) - Wed, 03/25/2015 - 7:30am

Quantification of morphine, morphine 6-glucuronide, buprenorphine, and the enantiomers of methadone by enantioselective mass spectrometric chromatography in whole blood.

Forensic Sci Med Pathol. 2015 Mar 24;

Authors: Christoffersen DJ, Brasch-Andersen C, Thomsen JL, Worm-Leonhard M, Damkier P, Brøsen K

Abstract
PURPOSE: Deaths among drug addicts are frequently caused by intoxication with methadone and/or morphine. These drugs are often used in combination with other drugs, such as buprenorphine. In addition, methadone is generally used as a mixture of R- and S-enantiomers. To date, a method for separation and quantitation of these specific drugs has not been developed. The aim of this study was to develop a sensitive enantioselective method for quantitation of morphine, its active metabolite morphine 6-glucuronide, buprenorphine, and R- and S-methadone, in a single analytical run.
METHODS: Whole blood samples were diluted with 0.5 mol/L ammonium carbonate buffer and extracted on a Bond Elut C18 solid-phase extraction column with an automatic solid-phase extraction system. Chromatographic separation was performed on a chiral alpha-1-acid glycoprotein column with an acetonitrile/ammonium acetate buffer (10 mmol/L, pH 7.0, 22:78 v/v) mobile phase. The whole blood concentrations of the drugs were quantified by mass spectrometry using their stable isotope-labeled compounds as internal standards.
RESULTS: The method was validated with respect to specificity, linearity, precision, limits of detection, and quantification and matrix effects. The precision (coefficient of variation) was below 15 %, and the accuracy was between 90 and 115 %.
CONCLUSIONS: This method will be useful for routine analyses in forensic laboratories where blood samples are frequently analyzed for drugs of abuse. In some cases, sudden death from methadone overdose is caused by the enantiomeric form of the methadone, which makes the enantiomer separation capability of this method important.

PMID: 25801127 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Analgesia in mice with experimental meningitis reduces pain without altering immune parameters.

Buprenorphine Research (PubMed) - Wed, 03/25/2015 - 7:30am

Analgesia in mice with experimental meningitis reduces pain without altering immune parameters.

ALTEX. 2015 Mar 24;

Authors: Mundt S, Groettrup M, Basler M

Abstract
Intracranial lymphocytic choriomeningitis virus (LCMV) infection is a widely used animal model to study virus-induced cytotoxic T cell (CTL) mediated meningitis and immunopathology. Nevertheless, this model causes severe pain and distress in mice, especially at later stages of the disease. Therefore, new treatment regimens to improve animal welfare have to be developed. In this study, we subcutaneously implanted ALZET® osmotic pumps continuously releasing buprenorphine to reduce pain in mice with LCMV-induced meningitis. Thereby, mice treated with buprenorphine demonstrated strongly reduced symptoms of pain. However, the LCMV-specific cytotoxic T cell response and the immune cell infiltration into the central nervous system (CNS) were unchanged in analgesia treated mice indicating that the LCMV-induced immune response was not altered in these mice. Taken together, we demonstrate that in this animal model for meningitis continuous buprenorphine treatment improves animal welfare without affecting the immune response.

PMID: 25800953 [PubMed - as supplied by publisher]

Categories: Bup Feeds

Interpretation of Urine Drug Testing Results in Patients Using Transdermal Buprenorphine Preparations for the Treatment of Chronic Noncancer Pain.

Buprenorphine Research (PubMed) - Wed, 03/25/2015 - 7:30am

Interpretation of Urine Drug Testing Results in Patients Using Transdermal Buprenorphine Preparations for the Treatment of Chronic Noncancer Pain.

Pain Med. 2015 Mar 20;

Authors: Markman JD, Barbosa WA, Gewandter JS, Frazer M, Rast S, Dugan M, Nandigam K, Villareal A, Kwong TC

Abstract
OBJECTIVE: To determine whether the prevailing liquid chromatography and tandem mass spectroscopy assay (LC-MS/MS) assay designed to monitor buprenorphine compliance of the sublingual formulation used in the substance abuse treatment setting can be extrapolated to the transdermal formulation used in the chronic pain treatment setting, which is 1000-fold less concentrated.
DESIGN: Retrospective chart review SUBJECTS: Self-reported compliant patients using the transdermal or sublingual formulations of buprenorhphine. Transdermal patch application was also visually confirmed during clinic visits.
METHODS: Urine drug test results from a LC-MS/MS were compared between samples from transdermal and sublingual patients.
RESULTS: While all sublingual patients tested positive for at least one metabolite of buprenorphine, only 69% of the transdermal patients did so. In addition, the most abundant metabolite in the transdermal patients was buprenorphine-glucuronide, as compared with norbuprenorphine-glucuronide in sublingual patients.
CONCLUSIONS: These data suggest that currently available urine drug tests for buprenorphine, including the more expensive LC-MS/MS based assays, may not be sufficiently sensitive to detect the metabolites from transdermal buprenorphine patients. This study highlights the need to evaluate the value and sensitivity of urine drug tests given the wide range of buprenorphine dosing in clinical practice. These results underscore the need for additional cost benefit analyses comparing different confirmatory drug testing techniques including many commercially available drug testing options.© 2014 Wiley Periodicals, Inc.

PMID: 25800409 [PubMed - as supplied by publisher]

Categories: Bup Feeds

“But YOU smoked weed when YOU were younger.”

Drug and Alcohol News (JoinTogether.com) - Wed, 03/25/2015 - 6:00am

“Marijuana is a plant. It’s natural. How harmful could it be?”

“But YOU smoked weed when YOU were younger.”

“Would you rather I drink alcohol? Weed is so much safer.”

Would you know what you’d say if confronted with these tough questions or arguments by your teen?

Marijuana is a hot topic. Between legalization in some states, the normalization of the drug in the media and pop culture and different ways of using (like “edible” cookies and candies, vaporizers and dabs), it’s becoming harder for parents to talk to teens about weed.

That’s why we created our new Marijuana Talk Kit. We want to help families navigate the changing marijuana landscape, and have productive, impactful conversations with their teens.

Inside the Talk Kit, you will find:

•Facts about marijuana
•Why marijuana is still risky for teens
•Ways to talk with your teen about marijuana
•What you should –  and shouldn’t –  say to your teen when talking about marijuana
•How to respond to your teen’s questions and arguments
•Resources to help

We know it’s hard, and we’re here to help.

The post “But YOU smoked weed when YOU were younger.” appeared first on Partnership for Drug-Free Kids.

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