5-Day Injectable Extended-release Buprenorphine Initiation in Non-opioid-tolerant Individuals in a Carceral Setting: A Case Series.

IF 4.2 3区 医学 Q1 SUBSTANCE ABUSE Journal of Addiction Medicine Pub Date : 2024-09-27 DOI:10.1097/ADM.0000000000001387
Matt Perdue, Reza Hosseini Ghomi, Paul Rees, Eric Arzubi
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Abstract

Background: Injectable extended-release buprenorphine (XR-Bup) addresses several barriers to the implementation of treatment with medications for opioid use disorder (MOUD) in carceral settings due to lower risk of diversion and reduced operational procedures. However, there is no standardized approach or guideline for initiating sublingual buprenorphine (SL-Bup) and transitioning to XR-Bup in persons with opioid use disorder (OUD) who are not actively using opioids, a clinical scenario commonly encountered in carceral settings.

Methods: We conducted a retrospective case series of non-opioid-tolerant men with OUD at a Montana Department of Corrections facility who initiated XR-Bup using a 5-day induction protocol between May 1, 2023, and November 1, 2023. Primary outcome was receipt of the initial XR-Bup injection. Secondary outcomes were toleration of SL-Bup induction protocol and active continuation of XR-Bup at time of discharge.

Results: Sixteen individuals initiated the SL-Bup induction protocol, and all were successfully transitioned to XR-Bup with no severe adverse effects. There were no required dose changes or severe adverse effects from SL-Bup induction. Two (12%) elected to discontinue XR-Bup due to commonly reported adverse effects. Fourteen (88%) remained on XR-Bup at discharge.

Conclusions: Five-day induction of SL-Bup and transition to XR-Bup may be considered for non-opioid-tolerant individuals with OUD in carceral settings.

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在囚禁环境中对阿片类药物无耐受性的人开始使用 5 天注射型缓释丁丙诺啡:病例系列。
背景:注射用缓释丁丙诺啡(XR-Bup)由于转移风险较低、操作程序较少,解决了在囚禁环境中实施阿片类药物使用障碍(MOUD)药物治疗的若干障碍。然而,对于不主动使用阿片类药物的阿片类药物使用障碍(OUD)患者,目前还没有启动舌下丁丙诺啡(SL-Bup)并过渡到 XR-Bup 的标准化方法或指南,而这是在殡葬机构中经常遇到的一种临床情况:我们对蒙大拿州劳教所中患有阿片类药物使用障碍的非阿片耐受性男性患者进行了回顾性病例系列研究,这些患者在 2023 年 5 月 1 日至 2023 年 11 月 1 日期间使用 5 天诱导方案开始使用 XR-Bup。主要结果是接受首次 XR-Bup 注射。次要结果是对 SL-Bup 诱导方案的耐受性和出院时继续积极注射 XR-Bup 的情况:16人开始接受SL-Bup诱导方案,所有人都成功过渡到XR-Bup,没有出现严重不良反应。在 SL-Bup 诱导治疗过程中,没有出现需要改变剂量或严重不良反应的情况。有两人(12%)因常见的不良反应而选择停用 XR-Bup。14人(88%)出院时仍在服用XR-Bup:结论:在囚禁环境中,对于不耐受阿片类药物的 OUD 患者,可以考虑在五天内诱导使用 SL-Bup 并过渡到 XR-Bup。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Addiction Medicine
Journal of Addiction Medicine 医学-药物滥用
CiteScore
6.10
自引率
9.10%
发文量
260
审稿时长
>12 weeks
期刊介绍: The mission of Journal of Addiction Medicine, the official peer-reviewed journal of the American Society of Addiction Medicine, is to promote excellence in the practice of addiction medicine and in clinical research as well as to support Addiction Medicine as a mainstream medical sub-specialty. Under the guidance of an esteemed Editorial Board, peer-reviewed articles published in the Journal focus on developments in addiction medicine as well as on treatment innovations and ethical, economic, forensic, and social topics including: •addiction and substance use in pregnancy •adolescent addiction and at-risk use •the drug-exposed neonate •pharmacology •all psychoactive substances relevant to addiction, including alcohol, nicotine, caffeine, marijuana, opioids, stimulants and other prescription and illicit substances •diagnosis •neuroimaging techniques •treatment of special populations •treatment, early intervention and prevention of alcohol and drug use disorders •methodological issues in addiction research •pain and addiction, prescription drug use disorder •co-occurring addiction, medical and psychiatric disorders •pathological gambling disorder, sexual and other behavioral addictions •pathophysiology of addiction •behavioral and pharmacological treatments •issues in graduate medical education •recovery •health services delivery •ethical, legal and liability issues in addiction medicine practice •drug testing •self- and mutual-help.
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