Buprenorphine for Prescription Opioid Dependence

C. Rollynn Sullivan, MD

Professor and Director, Addictions Programs
Department of Behavioral Medicine & Psychiatry
WVU School of Medicine,
Morgantown, WV

During the last two decades, reports of inadequate pain treatment have resulted in increased opioid prescribing, at times by physicians who were not adequately trained in pain and risk management. This has contributed to higher rates of nonmedical prescription opioid use among both patients and recreational users. Here, Dr. Sullivan discusses the distinction between opioid dependence and addiction, and new treatment approaches aimed at helping individuals wean themselves from prescription opioids. For example, the FDA has approved the opioid agonist buprenorphine in combination with naloxone for maintenance treatment of opioid dependence. Obstacles to treatment with buprenorphine remain, however, and research efforts are underway to standardize buprenorphine therapy.

References

1. Potter JS, Prather K, Kropp F, et al. A method to diagnose opioid dependence resulting from heroin versus prescription opioids using the Composite International Diagnostic Interview. Contemp Clin Trials. 2010;31:185-188.
2. Gilson AM. The concept of addiction in law and regulatory policy related to pain management: a critical review. Clin J Pain. 2010;26:70-77.
3. Mendelson J, Flower K, Pletcher MJ, Galloway GP. Addiction to prescription opioids: characteristics of the emerging epidemic and treatment with buprenorphine. Exp Clin Psychopharmacol. 2008;16:435-441.

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