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Buprenorphine, sold under the brand name Subutex among others, is an opioid used to treat opioid use disorder, acute pain, and chronic pain. [18] It can be used under the tongue (sublingual), in the cheek (buccal), by injection (intravenous and subcutaneous), as a skin patch (transdermal), or as an implant.
Buprenorphine/naloxone, sold under the brand name Suboxone among others, is a fixed-dose combination medication that includes buprenorphine and naloxone. [3] It is used to treat opioid use disorder, and reduces the mortality of opioid use disorder by 50% (by reducing the risk of overdose on full-agonist opioids such as heroin or fentanyl).
Injection site reactions (ISRs) are reactions that occur at the site of injection of a drug. They may be mild or severe and may or may not require medical intervention. Some reactions may appear immediately after injection, and some may be delayed. [1] Such reactions can occur with subcutaneous, intramuscular, or intravenous administration.
After buprenorphine became an accepted treatment in France in the mid-’90s, other countries began to treat heroin addicts with the medication. Where buprenorphine has been adopted as part of public policy, it has dramatically lowered overdose death rates and improved heroin addicts’ chances of staying clean.
Opioid agonist therapy (OAT) is a treatment in which prescribed opioid agonists are given to patients who live with opioid use disorder (OUD). [1] In the case of methadone maintenance treatment (MMT), methadone is used to treat dependence on heroin or other opioids, and is administered on an ongoing basis.
However, SAMHSA's clinical guidelines state that if the combination of buprenorphine and naloxone is injected by a regular user of buprenorphine or buprenorphine/naloxone, then the buprenorphine would still produce an agonist effect but the naloxone would fail to produce an antagonist effect.
Opioid replacement therapy (ORT), also known as opioid substitution therapy (OST) or Medications for Opioid Use Disorder (MOUD), involves replacing an opioid, such as heroin. [ 112 ] [ 113 ] Commonly used drugs for ORT are methadone and buprenorphine/naloxone ( Suboxone ), which are taken under medical supervision. [ 113 ]
After a non-fatal opioid overdose, subsequent methadone or buprenorphine initiation and use reduce the risk of overdose death by 59% and 38% respectively. Initiating buprenorphine in the emergency department is associated with lower mortality and increased adherence to opioid use disorder treatment programs. [24]
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